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病历摘要患者,男,32岁.于1991年3月6日因左膝关节剧痛2小时到某医院就医,诊断为风湿性膝关节炎并经口服盐酸平痛新(Nefopam hydrochloride)40mg后剧痛不缓解,而于3小时后转入我院.既往健康,除近2年有时出现双侧膝关节疼痛外,否认其他病史.体检:T36.4,P80,Bp17.0/12.0,呼吸平稳,神志清楚,表情痛苦.肺正常.心音明显低钝,心律绝对不齐,心率90次/分,未听到杂音,心界不大.腹平软,无压痛,肝脾未触及.四肢关节未见异常.血尿便常规,X线胸片和双膝关节片正常.心电图:V_1～V_5导联出现异常Q波和ST段明显抬高,Ⅱ、Ⅲ导联ST段轻度压低;心房颤动.诊断:急性广泛前壁心肌梗塞并心房颤动.刚检查完心电
Patient, male, 32 years old. On March 6, 1991, he was diagnosed with rheumatoid arthritis and was treated with 40 mg of Nefopam hydrochloride Pain relief, and transferred to our hospital after 3 hours. Past health, in addition to bilateral knee pain sometimes appear in recent 2 years, the denial of other medical history. Physical examination: T36.4, P80, Bp17.0 / 12.0, stable breathing , Clear mind, facial expression pain. Lung normal. Heart sound was significantly low blunt, heart rate is absolutely not Qi, heart rate 90 beats / min, no noise, heart is not big. Abdomen soft, no tenderness, liver and spleen not touched. No abnormalities.Hematuria is routine, normal X-ray and double knee joint card.Electrocardiogram: V_1 ~ V_5 leads abnormal Q wave and ST segment was significantly elevated, Ⅱ, Ⅲ leads ST segment mild depression; atrial fibrillation Diagnosis: Acute extensive anterior myocardial infarction with atrial fibrillation