患者女,56岁。因活动后胸闷、气喘半个月,加重3 h 入院。患者半个月前于活动后感胸闷、憋喘.休息后可缓解。外院治疗(具体不详)效果欠佳。入院当日晨安静时胸闷憋喘再次发作,难以忍受。既往无慢性阻塞性肺部疾病史。门诊 B 超示心包少量积液。门诊拟诊心包积液,冠心病,心功能不全和肺栓塞.收入院。体格检查:体温37.1℃,脉搏82次/min,呼吸19次/min,血压128/73 mm Hg(1 mm Hg=0.133 kPa),神清、口唇轻度紫绀.颈静脉无怒张。无胸膜摩擦感,双肺底闻及少许湿啰音。心界不大,未触及震颤。心律不齐,偶及早搏,各瓣膜听诊区未闻及明显杂音。双下肢无水 The female patient is 56 years old. Due to chest tightness and asthma for two weeks after the activity, he was hospitalized for 3 hours. The patient felt chest tightness and wheezing after being active for half a month before. He could be relieved after rest. Outpatient treatment (specifically unknown) was ineffective. When she was quiet on the morning of the hospital admission, she developed chest tightness and wheezing again and became unbearable. No previous history of chronic obstructive pulmonary disease. Outpatient B ultrasound showed a small amount of pericardial effusion. The outpatient department is interested in pericardial effusion, coronary heart disease, cardiac insufficiency and pulmonary embolism. Physical examination: body temperature 37.1°C, pulse 82 beats/min, respiration 19 breaths/min, blood pressure 128/73 mm Hg (1 mm Hg=0.133 kPa), Shen Qing, mild cyanotic lips, no jugular vein engorgement. There was no pleural friction, and the bottom of the lungs smelled of a little wet rales. The world of hearts is not large, and tremors have not been touched. Arrhythmia, occasional and premature beats, no apparent noise was heard in the valve auscultation areas. Double lower limbs without water