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患者男,64岁。因胸骨后压榨样疼痛5h入院,伴全身大汗淋漓、晕厥1次。查体:体温36.3℃,脉搏82次/min,心率82次/min,律齐,呼吸20次/min,血压82/46 mm Hg(1 mm Hg=0.133kPa),神清,双肺呼吸声音粗,主动脉瓣膜听诊区可闻及3/6级杂音,无心包摩擦声音,余未见明显异常。心电图示:Ⅱ、Ⅲ、aVF导联ST段抬高,V1~V6导联T波倒置,V3R~V5R导联ST段抬高。实验室指标:CK 1 677IU/L,CK-MB>80ng/ml,cTnI 49.75ng/ml,Myo 553.3ng/ml。初诊:冠心病、急性下壁、右室心肌梗死。
Patient male, 64 years old. 5h after the compression of the sternum due to admission, accompanied by sweating, syncope 1. Examination: body temperature 36.3 ℃, pulse 82 beats / min, heart rate 82 beats / min, law Qi, breathing 20 beats / min, blood pressure 82/46 mm Hg (1 mm Hg = 0.133kPa) Coarse, aortic valve auscultation area can be heard and 3/6 noise, no heart package friction sound, I no obvious abnormalities. ECG: Ⅱ, Ⅲ, aVF lead ST segment elevation, V1 ~ V6 lead T wave inversion, V3R ~ V5R lead ST segment elevation. Laboratory indicators: CK1 677IU / L, CK-MB> 80ng / ml, cTnI 49.75ng / ml, Myo 553.3ng / ml. New diagnosis: coronary heart disease, acute inferior wall, right ventricular myocardial infarction.