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1 病例介绍患者女.37岁.身高153cm、体重42kg,因劳力后心悸、气促3年,加重3个月入院.3年前出现劳力后心悸、气促,经休息后可以缓解.3个月前、无明显诱因胸骨下段闷痛、不受体位和呼吸的影响,体力活动后加剧、可以忍受.因“白细胞升高”在当地被诊为“胸膜炎”、于抗炎、补液治疗中出现心悸、气促、经常规抗心衰治疗无效而来我院.门诊心电图见:I呈Rs型.Ⅱ呈qrS型.Ⅲ、avF呈QS型.V_1呈rsR’S’型,V_2～V_5呈Rs型,V_6呈RS型,V_(3R)、V_(4R)呈qrs型.P_(v1)约0.25mV.V_1QRS时限约0.10～0.11s.ST:I、avL弓背抬高0.20mV.V_2抬高0.10mV.Ⅱ、Ⅲ、avF压低0.10～0.30mV.V_4～V_6压低0.05～0.10mV.肢体导联QRS电压Ⅰ+Ⅱ+Ⅲ小于1.50mV.电轴左偏60°.门诊疑“急性高侧壁心肌梗死”收入院.体检T36℃,BP14/11kPa.
1 case description Female patient .37 years old. Height 153cm, weight 42kg, after work-induced heart palpitations, shortness of breath 3 years, increased 3 months admitted to hospital .3 years ago after labor, palpitations, shortness of breath, after rest can ease .3 Months ago, there was no obvious incentive for the lower part of the sternum to be stuffy, not affected by posture and respiration, aggravated by physical activity, and endured because of “leukocytosis” being diagnosed locally as “pleurisy” in anti-inflammatory and rehydration treatments Appear heart palpitations, shortness of breath, routine anti-heart failure treatment ineffective come from our hospital.Outside the clinic electrocardiogram see: I was Rs type.Ⅱ was qrS type.Ⅲ, avF was QS type.V_1was rsR’S ’type, V_2 ~ V_5was Rs V_6R is RS type, V_ (3R), V_ (4R) is qrs type .P_ (v1) is about 0.25mV.V_1QRS time is about 0.10 ~ 0.11s.ST: I, avL bow lift 0.20mV.V_2 High 0.10mV.Ⅱ, Ⅲ, avF depression 0.10 ~ 0.30mV.V_4 ~ V_6 depression 0.05 ~ 0.10mV limb lead QRS voltage Ⅰ + Ⅱ + Ⅲ less than 1.50mV .Left axis 60 ° .Diagnosis “acute high Lateral myocardial infarction ”income hospital. Physical examination T36 ℃, BP14 / 11kPa.