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患者,女,65岁。于10天前劳累后出现胸骨后剧痛,伴心悸、胸闷、头晕、乏力、大汗淋离,无咳嗽咳痰,急到当地医院就诊。心电图示:①窦性心律;②左前分支阻滞;③P波高耸,以Ⅱ、Ⅲ、aVF导联为著。电压达0.3mV,呈肺型P波样改变,P—T。段抬高0.05mV;④前壁心肌缺血。给予口服消心痛、速效救心丸等药物治疗后,疼痛渐缓解。后每遇劳累即发作胸痛,性质同前。但因胸痛反复发作,于1995年2月19日到我院就诊。入院查体:口唇无明显紫绀,颈静脉轻度充盈,双肺呼吸音清,心界向左下稍大,心率96次/分,律整,心音低,无杂音,腹软,无压痛,双下肢无浮肿。复查心电图同前。胸透示:双肺(一),心脏稍大。以往无慢支、肺心病、高血压病史。入院诊断:①冠心病,单纯心房心梗(AI)②肺梗塞?入院后给予持续高流量吸氧,静滴硝酸甘油,复方丹参液等药物治
Patient, female, 65 years old. Pain in the chest after 10 days of exertion, accompanied by heart palpitations, chest tightness, dizziness, fatigue, sweating away, no cough and sputum, urgent visit to a local hospital. ECG: ① sinus rhythm; ② left anterior branch block; ③ P wave towering to Ⅱ, Ⅲ, aVF lead for. Voltage up to 0.3mV, was pulmonary P-wave changes, P-T. Segment elevation 0.05mV; ④ anterior myocardial ischemia. Give oral Xiao Xin Tong, quick save heart pills and other drug treatment, the pain gradually ease. After each episode of chest pain, the nature of the same. However, recurrent chest pain, on February 19, 1995 to our hospital. Admission examination: no obvious cyanosis of the lips, mild jugular filling, lung breath sounds clear, heart to the left slightly larger, heart rate 96 beats / min, law, heart sound low, no noise, abdominal soft, no tenderness, double Lower extremity without edema. Review the same ECG. Chest revealed: double lung (a), slightly larger heart. In the past without chronic bronchitis, pulmonary heart disease, history of hypertension. Admission diagnosis: ① coronary heart disease, simple atrial infarction (AI) ② pulmonary infarction? After admission to give sustained high-flow oxygen, intravenous nitroglycerin, compound Danshen solution and other drugs