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患者,男性,43岁。因反复胸痛、咳嗽、咯血并晕厥于1996年3月29日入院。患者于3年前因着凉出现咳嗽,咯痰带血丝,并胸痛,当时胸片示胸膜炎,按结核性胸膜炎治疗2月余,症状无好转。曾因一次重体力劳动出现剧烈胸痛,并咯鲜血数口,同时感心悸、呼吸困难,此后间隔2周,于活动中突然晕厥,数分钟后自行缓解。3年来,症状反复发作,先后诊为肺结核、心肌病、冠心病、心衰等。经对症治疗效果不明显故转来本院。发病以来无发热,两便正常。家庭成员无类似疾病。查体:体温36.7℃,脉搏120次/分,呼吸21次/分,血压13/10.5kPa。神志清,肥胖体质。右肺底呼吸音稍低,未闻及湿哕音,心界双侧扩大,心音低钝,听诊无杂音,腹软,肝脾未触及。双下肢轻度浮肿。实验室检查:WBC7.6×10~9/L,N0.70,L0.30,RBC4.0×10~(12)/L,
Patient, male, 43 years old. Due to repeated chest pain, cough, hemoptysis and syncope in March 29, 1996 admission. 3 years ago, the patient was coughing due to a cold, expectoration with bloodshot eyes, and chest pain. At that time, the chest radiograph showed pleurisy. According to tuberculous pleurisy treatment for more than 2 months, the symptoms did not improve. Had a heavy manual labor severe chest pain, and a few mouthfuls of blood, while feeling heart palpitations, breathing difficulties, then interval 2 weeks, sudden syncope in the activities, a few minutes to ease themselves. 3 years, the symptoms recurrent, has been diagnosed as tuberculosis, cardiomyopathy, coronary heart disease, heart failure and so on. The result of symptomatic treatment is not obvious transferred to the hospital. Since the onset of fever, two will be normal. Family members have no similar disease. Physical examination: body temperature 36.7 ℃, pulse 120 beats / min, breathing 21 beats / min, blood pressure 13 / 10.5kPa. Conscious, obese physique. Right lung bottom breath sounds slightly lower, no smell and wet 哕 sound, heart bilateral expansion, low heart sound blunt, auscultation without noise, abdominal soft, liver and spleen not touched. Lower extremity mild edema. Laboratory tests: WBC7.6 × 10 ~ 9 / L, N0.70, L0.30, RBC4.0 × 10-12 / L,