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男,57岁。入院前2小时突发心前区局限性剧痛,不放射,与心搏及呼吸无明确关系,无胸闷及压榨感、无大汗、呕吐、咳喘,休息不能缓解。有高脂血症4年,但无高血压病及心绞痛史。体查:体温36.5℃,脉搏80次,血压19.42/11.7kPa。痛苦面容,唇无紫绀,无颈静脉怒张;心前区第4肋间左锁骨中线处约有2×2cm范围的明显压痛区(与主诉疼痛部位一致),稍触压则剧痛难忍,局部无红肿;心界不扩大,心律齐,心音稍钝,无杂音,两肺呼吸音清,腹(-)。心电图正常。疑诊为肋间神经痛,胸
Male, 57 years old. 2 hours before admission, sudden precordial regional limitations of pain, no radiation, and heartbeat and breathing no clear relationship, no chest tightness and squeezing flu, no sweating, vomiting, cough, rest can not be alleviated. Have hyperlipidemia for 4 years, but no history of hypertension and angina. Physical examination: body temperature 36.5 ℃, pulse 80 times, blood pressure 19.42 / 11.7kPa. Painful face, lips cyanosis, no jugular vein engorgement; anterior intercostal left subclavian midline at about 2 × 2cm range of tenderness area (with the complained of the same site), a little touch of pressure is painful , No local swelling; heart does not expand, heart Qi Qi, heart sound a little blunt, no noise, breath sounds clear lungs, abdomen (-). Normal ECG. Suspected of intercostal neuralgia, chest