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患者男,55岁,已婚,农民。劳累后胸闷、气急5、6年,反复阵发性夜间呼吸困难2年。1年前心电图示左心室肥大,心房颤动,ST、T改变。近10天前劳累后胸闷、气急、夜间阵发性呼吸困难加剧再发。从站立位改平卧时常诱发心悸、黑朦,起初1-2天发作1次,每次持续几秒至十几秒后自行缓解,不出现晕厥。近3-4天每天发作3、4次,最多达一天8次,每次持续约2～4分钟,均伴晕厥,无胸痛、抽搐。半月来未服任何药物。否认有高血压史。家属中无猝死者。体检:呼吸24次/分,血压13.5/8kPa(100/60mmHg)。半卧位,神志清。口唇
Male patient, 55 years old, married, farmer. After exertion, chest tightness, shortness of breath 5, 6 years, repeated paroxysmal night dyspnea 2 years. 1 year ago ECG showed left ventricular hypertrophy, atrial fibrillation, ST, T changes. Tired after 10 days ago chest tightness, shortness of breath, increased paroxysmal nocturnal dyspnea recurrence. Supine from the standing position often induced heart palpitations, darkness, the first attack 1-2 days 1-2 times, each lasting several seconds to ten seconds to ease themselves, do not appear syncope. Nearly 3-4 days episodes of 3,4 times a day, up to 8 times a day, each lasting about 2 to 4 minutes, are associated with syncope, no chest pain, convulsions. Half a month has not served any drugs. Denied a history of hypertension. No sudden death in family members. Physical examination: breathing 24 times / min, blood pressure 13.5 / 8kPa (100 / 60mmHg). Semi-recumbent position, mind clear. Lips