论文部分内容阅读
患者女性,46岁,因劳力性心慌气短18年,间断浮肿、端坐呼吸5年于1986年11月1日入院。患者20多年前常低热及四肢关节痛。体检;T36℃,P110次/分,R24次/分,BP120/80。神清,端坐位,唇绀,颈静脉怒张。心界向左下扩大,心率110次/分,律绝对不齐,P_2>A_2,心尖区Ⅱ级/Ⅵ级收缩期吹风样杂音及舒张期滚筒样杂音。双肺闻及大量干湿罗音。腹膨隆,肝肋下5cm,质硬,脾未及。移动性浊音(+)。两下肢高度凹陷性浮肿。三大常规、血沉、抗“O”、血电解质均正常。胸片示:肺瘀血,右室、在房和左室扩大。心电图示;心房纤颤,右室肥厚。超声心动图示:二尖瓣
Female patient, 46 years old, because of exertional palpitation shortness of breath for 18 years, intermittent edema, sitting breathing for 5 years on November 1, 1986 admission. 20 years ago, patients with low fever and limb pain. Physical examination; T36 ℃, P110 beats / min, R24 beats / min, BP120 / 80. Clear, sitting, cyanosis, jugular vein engorgement. Heart to expand to the left, the heart rate of 110 beats / min, the law is absolutely missing, P_2> A_2, apical Ⅱ / Ⅵ systolic hair-like murmur and diastolic drum-like noise. The lungs smell a lot of wet and dry rales. Abdominal bulge, liver ribs 5cm, hard, spleen and time. Mobility (+). Two lower limbs highly depressed edema. Three conventional, ESR, anti “O”, blood electrolyte are normal. Chest radiograph shows: lung blood stasis, right ventricle, enlarged in room and left ventricle. ECG; atrial fibrillation, right ventricular hypertrophy. Echocardiography: mitral valve