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患者女,60岁。因原发性高血压病、冠心病并心律失常,于1990年5月1日第6次住院。心电图:频发房性早搏,慢性冠状动脉供血不足。查体:神志清,肥胖体型,颈静脉无怒张,双肺(一),心界不大,心率70次,律不整,可闻及早搏7～8次/分,A2>P2,心尖区可闻及ⅡSM。腹软,肝脾不大,双下肢不肿。入院后给予异搏定(常州制药厂生产)40mg,一日三次口服,早搏消失。于6月19日上午10时突感心悸、胸闷伴出汗,查心电图出现Ⅱ°窦房阻滞。此时异搏定服用总量达4620mg,西比灵服用总量75mg(6月14～6月19日),考虑为异搏定毒副反应,立即停药。给予对症处理,6月
Female patient, 60 years old. Due to essential hypertension, coronary heart disease and arrhythmia, on May 1, 1990 the sixth hospitalization. ECG: frequent atrial premature beats, chronic coronary insufficiency. A2: P2, apical area (a), the heart is not big, heart rate 70 times, irregular heartbeat, can be heard and premature beats 7 to 8 beats / min, A2 May smell and IISM. Abdomen soft, small spleen and liver, both lower extremity is not swollen. After admission given verapamil (Changzhou Pharmaceutical Factory) 40mg, three times a day orally, premature beats disappear. Sudden sense of heart palpitations, chest tightness with sweating at 10 am on June 19, check the ECG appears Ⅱ ° sinoatrial block. Verapamil at this time take the total amount of 4620mg, the total consumption of xibinger 75mg (June 14 ~ June 19), consider verapamil side effects, immediate withdrawal. Give symptomatic treatment, June