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例1 女,25岁。9个月前无诱因出现多食、消瘦、怕热、多汗、手抖、全身乏力、性情急躁。同时月经减少,最后停经。3个月前颈前肿大,在当地对症治疗。1个月前出现心前区不适、疼痛,呼吸困难。在当地医院诊断为“心房纤颇,心包积液”,应用抗生素治疗,未见好转来我院。查体:甲状腺Ⅱ度弥漫性肿大,质中等,有明显血管杂音,双肺呼吸音清晰,心前区轻度隆起,心尖搏动弥散,心界向两侧扩大。心率120/min,律不整。脉搏短拙,心尖区及肺动脉瓣区可闻及Ⅱ级收缩性杂音,肝右肋缘下5cm处可触及,
Example 1 Female, 25 years old. 9 months ago, there is no incentive to eat more food, weight loss, fear of heat, sweating, trembling, malaise, impatience. At the same time reduce menstruation, and finally menopause. Neck anterior swollen 3 months ago, symptomatic treatment in the local. 1 month ago precordial discomfort, pain, difficulty breathing. In the local hospital diagnosed as “atrial fibrillation, pericardial effusion,” the application of antibiotics, did not improve to our hospital. Examination: diffuse diffuse thyroid Ⅱ degree, medium quality, obvious vascular murmur, clear lung breath sounds, slightly elevated heart area, apex beating dispersion, the heart to both sides of the expansion. Heart rate 120 / min, irregular law. Short pulse, apex and pulmonary valve area can be heard and Ⅱ contracting murmur, 5cm under the right rib margins can be touched,