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患者男性,18岁,因反复发作心悸、气促5年,加重7天于1988年2月4日下午入院。入院体检:颈静脉怒张,心率110次/min,心律绝对不齐,心音强弱不等,心尖区可闻Ⅲ/Ⅳ级双期杂音,肝肋下6cm,剑尖下8cm,压痛(十),肝颈返流征(十)。心脏 B 超:二尖瓣狭窄伴关闭不全,三尖瓣关闭不全及相对狭窄,少量心包积液。心电图示:①快速型心房颤动;②右室大。临床诊断:风湿性心脏病,联合瓣膜病变,心功能Ⅳ级。往院期间进行强心、利尿、扩血管、抗感染等治疗,病情未见明显好转,最终死于循环、呼吸衰竭。附图为住院期间记录到的心电图,节律为
Male patient, 18 years old, due to recurrent heart palpitations, shortness of breath 5 years, increased 7 days in the afternoon of February 4, 1988 admission. Admission examination: jugular vein engorgement, heart rate 110 beats / min, the heart rhythm is absolutely not Qi, heart sound intensity ranging from apical area can be heard Ⅲ / Ⅳ double phase murmurs, hepatic ribs 6cm, tip under the 8cm, tenderness ), Liver reflux syndrome (ten). Heart B ultrasound: mitral stenosis with incomplete closure, tricuspid regurgitation and relatively narrow, a small amount of pericardial effusion. ECG shows: ① rapid atrial fibrillation; ② large right ventricle. Clinical diagnosis: rheumatic heart disease, valvular disease, cardiac function Ⅳ level. During the visit to the hospital cardiac, diuretic, vasodilator, anti-infection and other treatment, the disease did not significantly improved, eventually died of circulation, respiratory failure. The figure is recorded during hospitalization electrocardiogram, rhythm is