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患者,女,24岁,住院号159253。于1992年11月8日入院。主诉间歇性发热、关节疼痛2年伴心悸、胸闷、气短、下肢浮肿2月。2年前不明原因发热,体温39.0℃,伴全身关节疼痛,关节无红肿及功能障碍。外院曾诊为“类风湿关节炎”以青霉胺治疗半年.在治疗过程中仍有间歇性发热,于38.0～40.0℃不等,且有关节疼痛。近2周上述症状再次复发且出现心悸,胸前憋闷,下肢浮肿。入院查体:体温38.7℃,脉搏110min~(-1),呼吸26min~(-1),血压18/10kPa。慢性病容,贫血貌,颜面未见红斑,双肺呼吸音清晰,心尖搏动弥散,心界向两侧扩大,心音低钝,未闻及心脏杂音及心包摩擦音。肝剑下4cm,肋下2cm,质软,有压疼。移动性
Patient, female, 24 years old, hospital number 159253. Admitted to hospital on November 8, 1992. Chief complaint intermittent fever, joint pain for 2 years with palpitations, chest tightness, shortness of breath, lower extremity edema in February. 2 years ago unknown cause fever, body temperature 39.0 ℃, with joint pain, joint swelling and dysfunction. Outside the hospital has been diagnosed as “rheumatoid arthritis” penicillin treatment for six months in the course of treatment there are still intermittent fever, ranging from 38.0 to 40.0 ℃, and the joints pain. Nearly 2 weeks recurrence of the above symptoms and palpitations, chest oppressed, lower extremity edema. Admission examination: body temperature 38.7 ℃, pulse 110min ~ (-1), breathing 26min ~ (-1), blood pressure 18 / 10kPa. Chronic disease, anemia appearance, face no erythema, lungs breath sounds clear, apex pulsation dispersion, the heart to both sides of the expansion, low heart sound blunt, no smell and cardiac murmurs and pericardial friction. Under the liver sword 4cm, rib 2cm, soft, with tenderness. Mobility