患者女性,68岁,因反复咳嗽、咯痰10余年,心悸、气喘5年,呕血、黑便1天入院,无使用洋地黄史。体检:神智模糊,口唇轻度发绀,两肺叩诊呈清音,呼吸音减弱,双下肺可闻及中等量湿罗音,心尖搏动以剑突下明显,心律不齐,可闻及奔马律。临床诊断:(1)慢性哮喘性支气管炎,肺气肿,肺心病;(2)上消化道出血。入院后心电图(附图)示:心房率220次/min,心室 Female, 68 years old, due to repeated cough, expectoration for more than 10 years, palpitations, asthma for 5 years, hematemesis, melena 1 day admission, no use of digitalis history. Physical examination: blurred vision, mild lip cyanosis, percussion lungs were clear tone, breath sounds weakened, double lower lungs can smell moderate amount of wet rales, apical beats significantly under the xiphoid, arrhythmia can be heard galloping . Clinical diagnosis: (1) chronic asthmatic bronchitis, emphysema, pulmonary heart disease; (2) upper gastrointestinal bleeding. After admission electrocardiogram (with photos) shows: atrial rate 220 beats / min, ventricular