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例1男,60岁。因突发剑突下疼痛伴头晕1h于2007年1月6日就诊。患者晨起散步时突发剑突下刺痛伴胸闷、大汗、乏力,随后出现头晕、黑矇,在搀扶下步入急诊室。既往高血压病史10余年,规律服药,否认其他病史。查体:双侧上肢血压均为75/60mmHg,余无阳性体征。心电图:大致正常。生化、心肌酶、血常规均正常。给予升压、扩容治疗后,监测右上肢血压无恢复,2h后以“胸痛、低血压原因待查”收入冠心病监护病房。入院查体:T36.5℃,P76次/min,BP左上肢130/70mmHg,右上肢50/30mmHg,神清,自动体位,双肺呼吸
Example 1 male, 60 years old. Due to sudden xiphoid pain with dizziness 1h on January 6, 2007 treatment. Patients with morning sickness when walking under the sudden xiphoid tingling chest tightness, sweating, fatigue, then dizziness, darkness, in the arm into the emergency room. Previous history of hypertension over 10 years, regular medication, denied other medical history. Examination: bilateral upper limb blood pressure are 75 / 60mmHg, I no positive signs. ECG: roughly normal. Biochemical, myocardial enzymes, blood are normal. Give boost, dilatation treatment, monitoring the right upper limb blood pressure without recovery, 2h after the “chest pain, hypotension causes to be investigated ” income coronary care unit. Admission examination: T36.5 ℃, P76 times / min, BP left upper limb 130 / 70mmHg, right upper limb 50 / 30mmHg, Shen Qing, automatic position, lungs breathing