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患者男,34岁。因反复发作心悸半年、晕厥2次入院。心悸发作持续数分钟、数小时乃至数天不等。晕厥时 ECG 示室颤。发作间期体力活动正常。体格检查:血压12/9 kPa(1kPa=7.5mmHg),脉搏150次/分,心界向左扩大,心音钝,可闻及奔马律,心率150次/分,律基本齐。肺部未闻及啰音。ECG:阵发性室性心动过速,左束支阻滞,提示异位激动源于右心室。X 线胸片:心影梨形,右心室扩大。心脏 B 型超声波检查:左室未见异常,右室扩大(内径46mm),右室游离壁厚7mm。MRI:右心
Patient male, 34 years old. Due to recurrent palpitations for six months, 2 admitted to hospital. Palpitation attacks last a few minutes, hours and even days. Syncope ECG showed ventricular fibrillation. Intermittent physical activity was normal. Physical examination: blood pressure 12/9 kPa (1kPa = 7.5mmHg), pulse 150 beats / min, heart to the left to expand, heart sound blunt, can be heard galloping, heart rate 150 beats / min, the law of basic Qi. Pulmonary unheard and rales. ECG: paroxysmal ventricular tachycardia, left bundle branch block, suggesting that ectopic excitement from the right ventricle. X-ray: heart shadow pear, right ventricular enlargement. Heart B-mode ultrasound: no abnormal left ventricle, right ventricular enlargement (diameter 46mm), right ventricular free wall thickness 7mm. MRI: Right heart