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硝苯吡啶作为治疗高血压病、冠心病及心衰药物应用于临床,其对心血管的副作用可引起心动过速。但致心房纤颤尚无报道。笔者曾遇1例,报告如下。 1.病例摘要患者王××,男,63岁。因头晕头痛10年,加重1周入院。入院时查体;血压28/14kPa,脉搏88次/分。神志清,语言流利,呼吸平稳,双肺无罗音。心界略向左扩大,心率88次/分,律正,第一心音增强,A_2>P_2。四肢功能正常,腱反射正常,病理反射阴性。心电图大致正常。入院诊断高血压病。口服复方降压片和牛黄降压丸治疗1周,疗效不佳,改用硝苯吡啶10mg每日3次舌下含服,用药前血压24/14kPa,心率84次/分,律正。心电图正常。患者没遵医嘱,自服硝苯吡啶40mg,连服3次后,出现头晕,心悸及不适感,测血压18/9kPa,心率110次/分,节律
Nifedipine as a treatment of hypertension, coronary heart disease and heart failure drugs used in clinical, its cardiovascular side effects can cause tachycardia. However, no report of atrial fibrillation. I have encountered a case, the report is as follows. 1. Case summary Patient Wang × ×, male, 63 years old. 10 years due to dizziness and headache, increased 1 week admission. Physical examination at admission; blood pressure 28 / 14kPa, pulse 88 beats / min. Consciousness, fluent language, smooth breathing, lungs without rales. Heart slightly expanded to the left, heart rate 88 beats / min, law positive, the first heart sound increased, A_2> P_2. Extremities function properly, tendon reflexes normal, pathological reflex negative. ECG roughly normal. Admission diagnosis of hypertension. Oral compound antihypertensive tablets and bezoar antihypertensive pill for 1 week, poor efficacy, switch to nifedipine 10mg 3 times a day sublingual, blood pressure before treatment 24 / 14kPa, heart rate 84 beats / min, law is positive. Normal ECG. Patients did not follow the doctor’s advice, self-nifedipine 40mg, and even served 3 times, dizziness, palpitation and discomfort, blood pressure 18 / 9kPa, heart rate 110 beats / min, rhythm