病例:男性,14岁。患者曾于入院前19天受凉后发热、体温达40℃,伴轻度咳嗽,咳痰及阵发性胸痛、气短、心悸。在院外以“风心病”诊治,体温降至正常,胸痛、气短、心悸无缓解。入院当日大便时,自觉症状加重,在奔跑中昏倒,意识丧失,历时不详,急诊送医院。入院体检:体温37℃,脉搏108,呼吸16,血压12.5/8.5kPa,神志清楚,面色苍白,颈静脉怒张,肝颈回流征阳性。双肺呼吸音清晰,心浊音界向左扩大至锁骨中线外1cm,心尖区心音低钝,心率108次/分,律齐。心尖区可闻及Ⅰ-Ⅱ级收缩期杂音,主动脉瓣区、肺动脉瓣区可闻及Ⅲ级以上收缩期杂音。腹软,肝肋下2cm,触痛,脾未触及。双下肢无水肿。WBC18.2×10~9/L,N0.77,L0.21;Hb89.8g/L。心电图提示窦性心动过速,数个导联ST～T段 Case: Male, 14 years old. Patients had fever 19 days before admission, fever, body temperature reached 40 ℃, with mild cough, sputum and paroxysmal chest pain, shortness of breath, heart palpitations. Outside the hospital with “rheumatic heart disease” diagnosis and treatment, body temperature dropped to normal, chest pain, shortness of breath, palpitations no relief. The day of admission stool, conscious symptoms worsened, fainting in the run, loss of consciousness, lasted for an unknown, emergency hospital. Admission physical examination: body temperature 37 ℃, pulse 108, breathing 16, blood pressure 12.5 / 8.5kPa, conscious, pale, jugular vein engorgement, liver reflux syndrome positive. Breath sounds clear lungs, heart dullness extended to the left clavicle to the left 1cm, apical low heart blunt, heart rate 108 beats / min, law Qi. Apex area can be heard Ⅰ-Ⅱ systolic murmur, aortic valve area, pulmonary valve area can be heard and Ⅲ grade above systolic murmur. Abdomen soft, liver ribs 2cm, tenderness, spleen not touched. No lower extremity edema. WBC18.2 × 10 ~ 9 / L, N0.77, L0.21; Hb89.8g / L. ECG prompted sinus tachycardia, several lead ST ~ T segment