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患者,男,14岁,学生。主因发烧、咽痛、心前区持续性疼痛2天,剧痛6小时入院。入院前2天因受凉开始发烧,体温达39.2℃左右,伴咽痛、心前区持续性闷痛,心慌。肌注安痛定、青霉素,体温下降至37.5℃。入院前6小时无诱因心前区剧痛,持续不缓解,全身出冷汗,急诊住我院。既往健康。查体:T37.3℃,P90次,R20次,BP15/11kPa,咽充血,心律90次,律规整,各瓣膜区未闻杂音,S_1减弱,P_2>A_2,双肺呼吸音清晰。心电图:窦性心律,QRS波群无Q波,肢导低电压,ST段Ⅰ、Ⅱ、aVL、V1～5抬高0.3～0.5mv。超声心动图:心底短轴找到主动脉根部,横切面看到左冠状动脉主干,其壁粗糙,不光滑,增厚,反光增强。化验血GOT46.5u,LDH495u。
Patient, male, 14 years old, student. Mainly due to fever, sore throat, precordial persistent pain for 2 days, 6-hour painful admission. 2 days before admission due to cold began to have a fever, body temperature reached 39.2 ℃, with sore throat, precordial persistent nausea, palpitation. Intramuscular An for pain, penicillin, body temperature dropped to 37.5 ℃. 6 hours before admission, no incentive for precordial pain, continued to not relieve, the body out of cold sweat, emergency hospital stay. Past health. Examination: T37.3 ℃, P90 times, R20 times, BP15 / 11kPa, pharyngeal congestion, heart rate 90 times, the law of regulation, the valve area unheard noise, S_1 weakened, P_2> A_2, lung breath sounds clear. ECG: sinus rhythm, QRS wave group Q wave, low limb lead, ST segment Ⅰ, Ⅱ, aVL, V1 ~ 5 elevation 0.3 ~ 0.5mv. Echocardiography: Myocardial short axis found aortic root, cross-section saw the left main coronary artery, the wall rough, not smooth, thickening, enhanced reflex. Blood test GOT46.5u, LDH495u.