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患者男性,31岁,平素健康,于参加打球半小时后突感心前区疼痛伴大汗淋漓、面色发青,自用“救心油”搽心前区,疼痛减轻、出汗渐止,遂来院急诊。检查:BP110/75,脉搏快而不齐,难以计数,心脏听诊绝对不规则,未闻杂音,肺(一)。化验:血钾13mg％,GOT正常,ESR3mm/h。心电图示预激综合征(WPW)合并快速型房颤(Af)(图1)即予心得安和补钾等治疗,10小时后转为窦性心律、A型WPW(图2)。图1为入院时描记的aVF,V_1、V_3和V_5导联:1.未见明确的P波;2.QRS波宽大畸形,心室率平均250次/分;3.R-R绝对不规则,QRS波起始处可见粗钝的δ波;4.大部分ST段与R波下行支及T波前支连成一向下的斜线,T波倒置。据此判断为WPW合并快速型Af,但需排除阵发
Patients, male, 31 years old, usually healthy, half an hour after participating in the play in front of sudden pain with sweating, looking blue, self-help “save the heart” paint heart area, pain relief, sweating, then to hospital emergency . Check: BP110 / 75, fast and irregular pulse, difficult to count, heart auscultation is absolutely irregular, unheard noise, lung (a). Laboratory: serum potassium 13mg%, GOT normal, ESR3mm / h. Electrocardiogram-induced WPW (WPW) with atrial fibrillation (Af) (Figure 1) was treated with diazepam and potassium supplementation. Ten hours later, they were switched to sinus rhythm and type A WPW (Figure 2). Figure 1 shows the aVF, V_1, V_3 and V_5 leads recorded on admission: 1. No clear P wave; 2. QRS large wave deformity, ventricular rate average 250 beats / min; 3. RR absolutely irregular, QRS wave The beginning of the rough dull δ waves; 4. Most of the ST segment and R wave descending branch and T wave anteroposterior continuous oblique line, T wave inversion. Accordingly, it is judged that WPW merges fast type Af, but it is necessary to exclude the paroxysm