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患者女,31岁,住院号293724。八个月前,因感冒开始咳嗽,未能治愈;此后月余,开始咯血伴心慌,气短,并出现夜间阵发性呼吸困难,不能平卧。如是发作三次。病情发展,出现颜面、下肢浮肿,上腹胀满。院外曾以“气管炎、病毒性心肌炎”给予多种治疗无效。四天前,因劳累致上述症状复发,门诊以“心肌炎”、心功不全Ⅱ级收治。既往健康,无风湿史。查体:T36.8℃,P108,R24,BPl20/80。贫血外貌,呼吸略促,半卧位,下肢轻度浮肿,口唇无紫绀,无颈静脉充盈。心尖部闻及 SMⅢ、舒张期奔焉律;三尖瓣区可闻及 SMⅢ、DMⅢ,随体位改变,时隐时现。肺肝脾(一)。腹水征(一)。无奇脉。化验:Hb 12g,WBC 15,600,ESR52～81mm/小时。肝功:ASO 等均在正常范围。心脏 X 线平
Female patient, 31 years old, hospital number 293724. Eight months ago, the patient started to cough because of a cold and failed to heal. After more than a month, hemoptysis started with palpitation, shortness of breath, and paroxysmal nocturnal dyspnea. If the attack three times. Condition, there face, lower extremity edema, abdominal fullness. Hospital had “bronchitis, viral myocarditis” given a variety of treatment is invalid. Four days ago, due to fatigue caused by the recurrence of these symptoms, out-patient to “myocarditis”, heart failure grade Ⅱ admitted. Past health, no history of rheumatism. Physical examination: T36.8 ℃, P108, R24, BPl20 / 80. Anemia appearance, breathing a little, semi-recumbent, mild swelling of lower limbs, lips without cyanosis, no jugular vein filling. Apex smelt and SM Ⅲ, diastolic Ben Yan law; the tricuspid valve area can be heard and SM Ⅲ, DM Ⅲ, with the body position changes, when the hidden. Liver and spleen (A). Ascites sign (a). No miraculous. Laboratory: Hb 12g, WBC 15,600, ESR 52 ~ 81mm / hour. Liver function: ASO, etc. are in the normal range. Heart X-ray flat