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第一次查房主治医师:请实习医师报告病例。实习医师:患者,男,58岁。于睡眠中突发胸骨后压榨样疼痛持续45分钟,并向左上肢放散。面色苍白,烦躁不安,大汗淋漓,濒死感。于1988年2月1日5时半来急诊。心电图:IavL。V_2—V_5 ST段呈弓背向上抬高。示:急性广泛前壁、高侧壁心肌梗塞(超急期改变)。予吸氧、注射止痛剂,静点利多卡因后住院。追问病史近1年来多次出现劳累后心悸、气短。1周来每于爬坡或上楼时心慌、气短、乏力。休息后缓解。既往高血压病史14年,曾患溃疡病及结核性胸膜炎。有烟酒嗜好,无药敏史。查体:
The first rounds attending physician: Please interns report cases. Intern: Patient, male, 58 years old. Sudden chest sternum during sleep press-like pain sustained 45 minutes, and to the left upper extremity. Pale, irritable, sweating, sense of nearness. At 0530 on February 1, 1988, an emergency department was held. ECG: IavL. V_2-V_5 ST-segment bow raised upward. Show: Acute extensive anterior wall, high side wall myocardial infarction (hyperacute change). To oxygen, painkillers, intravenous lidocaine hospitalization. History of the past few years to ask repeated fatigue palpitations, shortness of breath. 1 week every time climbing or upstairs palpitation, shortness of breath, fatigue. Ease after rest Previous history of hypertension for 14 years, had ulcer disease and tuberculous pleurisy. Alcohol and tobacco have a hobby, no history of drug sensitivity. Physical examination: