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例1 患者男性,57岁,胸骨后隐痛10天入院,入院前一日晚11时突然胸骨后压榨性痛,口含硝酸甘油疼痛缓解后送我院急诊时,突然意识、心音丧失,血压为零。经抢救意识恢复送至病房。查体:神清,血压90/60,心率72次,律齐,s_1↓,有s_4,心电监护示窦性心律,V_1～V_s ST 段轻度下移。住院当日晚11时,病人又突感胸骨后压榨样痛,持续半小时,EKGV_1～V_4ST 段水平型压低,对应导联ST 段上抬无Q 波,立即给以扩血管治疗后疼痛缓解,胸前导联ST 段恢复正常,约半小时后病人再次发生室颤,经综合治疗心电图正常。第二天加用硝酸甘油点滴,硝苯吡啶口含,未再发生心绞痛。实验窒检查CPK17.8u,CPKMB0.4μ,SGOT<40u,LDH320u。临床诊断:变异性心绞痛合并心室颤动。
Case 1 male, 57 years old, post-sternum pain 10 days admitted, 11 days before admission at 11 o’clock suddenly after a sudden chest pain, oral nitroglycerin pain relief sent to our hospital emergency, sudden awareness, loss of heart sound, blood pressure zero. Rescue consciousness restored to the ward. Examination: Shenqing, blood pressure 90/60, heart rate 72 times, law Qi, s_1 ↓, there s_4, ECG monitoring showed sinus rhythm, V_1 ~ V_s ST segment slightly down. On the evening of the 11th day of hospitalization, the patient again felt painful squeezing of the sternum for half an hour. The level of EKGV_1 ~ V_4ST was depressed and the Q-wave of the corresponding lead ST segment elevation was immediately delivered to relieve the pain after vasodilation. The chest ST lead before the lead back to normal, about half an hour after the occurrence of ventricular fibrillation again, the comprehensive treatment of normal ECG. The next day with nitroglycerin drip, nifedipine mouth, no recurrence of angina pectoris. Experimental suffocation check CPK17.8u, CPKMB0.4μ, SGOT <40u, LDH320u. Clinical Diagnosis: Variant Angina with Ventricular Fibrillation.