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患者女.7岁.发现紫绀3年伴活动后气急加重于1986年5月26日来我院心血管门诊就诊。体检:R24次/分,PB8次/分.B P12.8/9.2kPa.皮肤粘膜未发现毛细血管扩张和血管瘤.中度紫绀和杵状指趾.胸廓无畸形,双肺呼吸音清.心界不大.心率88次/分.律齐.心前区未闻及心脏和血管杂音,腹软.肝脾未及.神经系统无异常发现.心电图:窦性心律不齐。正位胸片示右肺野中、内带近右心缘处6×4cm结节状阴影.透视下阴影呈搏动性和肺动脉搏动一致,心影大小正常,双肺其他部位纹理正常。复诊时发现背部右肩下胛角相当于第6、7肋间Ⅱ～Ⅲ级柔和连续性血管杂音伴细颤。入院后检查:Hb150g/L.RBC4.72×10~(12)/L.红细胞压积54％。二维超声心动图示房室间隔完整,大血管位置正常,心腔大小和瓣膜活动无异常。右心导管检查来发现心内异常通道,右心各部压力正常.右心各部无血氧阶差及分流。动脉血氧饱和度87％
Patients were female .7 years old .Cyzoosis was found in 3 years with activity aggravate in May 26, 1986 to our hospital cardiovascular clinic. Physical examination: R24 beats / min, PB8 beats / min.B P12.8 / 9.2kPa. No evidence of telangiectasia and hemangiomas in the skin and mucous membranes. Moderate cyanosis and clubbing toe. Heart is not heart rate 88 beats by dre. Law Qi. Precordial area did not hear heart and vascular murmur, abdomen soft. Liver and spleen not yet. Nervous system no abnormality. Electrocardiogram: sinus arrhythmia. The anteroposterior chest radiograph shows the right lung field, with a 6 × 4cm nodular shadow near the right heart.Patients in shadows under fluoroscopy showed consistent pulsatile pulmonary artery pulsation, normal cardiac size and normal texture in other parts of the lung. The referral when found on the right shoulder shoulder blade angle equivalent to the first 6,7 intercostal Ⅱ ~ Ⅲ soft continuous vascular murmur with small tremors. After admission examination: Hb150g / L.RBC4.72 × 10 ~ (12) / L. Hematocrit 54%. Two-dimensional echocardiography showed atrioventricular septum integrity, normal vessel position, cardiac size and valve activity was normal. Right heart catheterization to find the abnormal heart channel, right heart pressure normal department .Heart of the right heart blood oxygen level and diversion. Arterial oxygen saturation 87%