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患者,男,55岁。自1982起因反复胸闷、心慌、气促并进行性加重伴夜间不能平卧曾住我院,拟诊“扩张性心肌病伴心包积液”,先后给予抗炎等治疗无效,后经利尿剂和营养心肌治疗,病情好转出院。近半年来,因心悸、气短、胸闷加重,于1990年11月16日收治我科。体检:T 36℃,P 100次,R 28次,BP 14/10kPa,颈静脉怒张,甲状腺不大,两肺(-);心界向两侧扩大,HR 100次,律齐,心音低而远,无S_3S_4,无杂音,有奇脉;肝肋下6cm,剑下7cm,质韧,无压痛;脾肋下未及;腹水征(-),下肢不肿。辅检:血常规正常,
Patient, male, 55 years old. Since 1982, due to repeated chest tightness, palpitation, shortness of breath and progressive aggravated with night can not lie down had lived in our hospital, proposed “dilated cardiomyopathy with pericardial effusion,” has given anti-inflammatory treatment is invalid, after diuretics and Nutritional cardiomyopathy, improved condition and discharged. Nearly six months, due to heart palpitations, shortness of breath, chest tightness, admitted to our department on November 16, 1990. Physical examination: T 36 ℃, P 100 times, R 28 times, BP 14 / 10kPa, jugular vein engorgement, thyroid is not large, both lungs (-); heart to both sides of the expansion, HR 100 times, law Qi, low heart sound And far, no S_3S_4, no noise, a strange pulse; liver rib 6cm, sword 7cm, quality and tough, no tenderness; spleen and ribs did not; ascites sign (-), lower extremity is not swollen. Auxiliary examination: normal blood,