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患者男,56岁,因胸闷、心慌、心前区不适1天就诊。以往有高血压史,从未取过洋地黄。查体:Bp14/10kPa。甲状腺无肿大。双肺呼吸音清。心界无扩大,心率106次/min,呈房颤律,各瓣膜区未闻及器质性杂音。腹软,肝脾未扪及。ECG示房颤,偶见数宽大畸形QRS波。临床诊断冠心病、房颤伴差异性传导、偶发定性早搏。给予50％葡萄糖液20ml加西地兰0.4mg静注,用药后约半小时复查ECG示宽大畸形QRS波增多时呈二联律,且在Ⅱ导联上见连续三个宽大畸形QRS波。临床考虑为室性
Male patient, 56 years old, due to chest tightness, palpitation, precordial discomfort 1 day treatment. In the past, there was a history of hypertension and digitalis had never been taken. Physical examination: Bp14 / 10kPa. Thyroid without swelling. Breath sounds clear lungs. No expansion of the heart, heart rate 106 beats / min, was atrial fibrillation law, the valve area has not heard of organic murmur. Abdomen soft, liver and spleen not palpable. ECG showed atrial fibrillation, occasionally large deformity QRS wave. Clinical diagnosis of coronary heart disease, atrial fibrillation with differential conduction, occasional qualitative premature beats. Give 50% glucose solution 20ml plus cedilanid 0.4mg intravenous injection, about half an hour after treatment review ECG showed large deformity QRS wave was increased when the law of the diplopia, and in the lead Ⅱ to see three large deformed QRS wave. Clinical consideration for ventricular