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患者男性,58岁,因心慌、胸闷、气短四年,加重伴浮肿一月于1989年2月7日入院。体查:Bp13/8kPa,HR72次/分,心律不齐,早搏8次/分,心尖区可闻Ⅱ级收缩期杂音,肝脏在右肋缘下锁骨中线2cm 处可及,双踝部凹陷性水肿。心电图诊断:窦性心律伴游走节奏点,频发房性早搏。入院诊断:冠心病,房性早搏,心功能Ⅲ级。入院后口服异搏定10mg,3次/日,治疗十天效果欠佳,遂停用。三天后给予心律平70mg+50%葡萄糖20ml静脉缓慢注射,继以心律平210mg+10%葡萄糖200ml 静脉滴注,15滴/分,早搏消失,HR72次/分,心电图正常.次日改用口服,150mag,3次/日.第四日上午心电图为完全性右束支传导阻滞,下午患者出现眼前发黑,胸闷,HR56次/分,心律不齐。心电图诊断:窦性停搏伴交界性逸搏,偶
Male patient, 58 years old, due to palpitation, chest tightness, shortness of breath for four years, increased with edema in January February 1989, admitted to hospital. Physical examination: Bp13 / 8kPa, HR72 beats / min, arrhythmia, premature beats 8 beats / min, apex symphysis can be heard systolic murmur, the liver in the right subcostal midline of the clavicle 2cm can reach, Edema. ECG diagnosis: sinus rhythm with walking rhythm point, frequent atrial premature beats. Admission diagnosis: coronary heart disease, atrial premature beats, heart function Ⅲ grade. After oral administration of verapamil set 10mg, 3 times / day, the treatment of ten days less effective, then disabled. Three days later, 70 mg of ropivacaine and 20 ml of glucose were intravenously injected slowly, followed by intravenous infusion of 210 ml of heart rate 210 mg + 10% glucose, 15 drops / minute, disappearance of premature beats, HR 72 beats / minute, normal electrocardiogram , 150mag, 3 times / day on the fourth morning ECG complete right bundle branch block, the afternoon appeared black eyes, chest tightness, HR56 beats / min, arrhythmia. ECG diagnosis: sinus arrest with borderline escape, even