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患者男,65岁,因突然胸前区剧痛,伴大汗、气促入院。体查:T不升,P70次/分,R26次/分,BP220/120mmHg。急性痛苦病容,神清,肺部听诊呼吸音低钝,可闻小水泡音。既往有高血压病史10年。入院查心电图:窦性心律,电轴左偏,完全性右束支传导阻滞。入院诊断:胸痛原因待查:急性肺栓塞?急性心肌梗死?肺部感染、高血压病Ⅲ期。查心肌酶均正常,次日上午再次突发胸前区剧痛。呼吸困难、晕厥、阿一斯综合征发作,心电图示:窦性心律,心电轴右偏,完全性右束支传导阻滞。Ⅰ导联出现深S波,avR导联R波增高,V_1导联R’波较前增
Male patient, 65 years old, due to sudden chest pain, sweating, shortness of breath hospitalized. Physical examination: T does not rise, P70 beats / min, R26 beats / min, BP220 / 120mmHg. Acute pain, soothing, lung auscultation breath sounds low blunt, can be heard a small blisters sound. Previous history of hypertension 10 years. Admission check ECG: sinus rhythm, left axis deviation, complete right bundle branch block. Admission diagnosis: the cause of chest pain to be investigated: acute pulmonary embolism? Acute myocardial infarction? Pulmonary infection, hypertension? Check myocardial enzymes were normal, the next morning chest area again sudden pain. Dyspnea, syncope, Als Syndrome attack, ECG: sinus rhythm, right deviation of the ECG axis, complete right bundle branch block. Ⅰ lead appeared deep S wave, av R lead R wave increased, V_1 lead R ’wave increased earlier