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1例中年男性患者有支气管源性癌肿外科治疗病史,急诊室初诊见病者衰竭,物理检查示有15mmHg的奇脉,胸部X线照片示心脏轮廓显著增大,心电图、超声心动图异常。超声心动图在心脏前后示有大量心包积液。每间隔1个心动周期的心脏摆动引起心电图上的交替性电变化。在大量心包积液内的心脏摆动最常出现在每1个心动周期,而不是在每隔1个心动周期,如本例所示。这种摆动改变了瓣膜的活动,例如,可能误诊为二尖瓣脱垂。在心包填塞时已注意到,在QRS后很快出现的右心室的心外膜活动所形成的切迹和伴有二尖瓣E-F坡度)的下降,正如超声心动图所证明的,在心脏填塞时吸气性的左心室压缩,可能代表心
One middle-aged male patient had a history of surgical treatment of bronchogenic carcinoma, a newly diagnosed emergency patient with pathological failure, a physical examination showing odd veins of 15 mmHg, a chest X-ray showing a significant increase in cardiac contours, an abnormal electrocardiogram and echocardiogram . Echocardiography showed a large amount of pericardial effusion around the heart. Heartbeats at every other cardiac cycle cause alternating electrical changes on the ECG. Cardiac oscillations within a large amount of pericardial effusion most often occur every 1 cardiac cycle, not every other cardiac cycle, as shown in this example. This swing changes the activity of the valve, for example, may be misdiagnosed as mitral valve prolapse. At the time of pericardial tamponade, there has been noted a decrease in the notch formed by the epicardial activity of the right ventricle immediately after QRS and accompanied by a decrease in mitral EF gradient), as evidenced by echocardiography, Inspiratory left ventricular compression may represent the heart