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例1,男,56a,反复心慌心悸、胸闷气急8a,近3mo 加重于1992年2月10日入院。PE:神清,BP:16/10kPa(150/75mmHg),端坐呼吸,两肺底湿罗音,心界向左扩大,心尖搏动(氵弥)散,HR:105次/min,P_2>A_2,心尖部闻及Ⅱ/Ⅵ收缩期杂音,肝肋下2cm,肝颈静脉返流征阳性,双下肢指凹性水肿。临床诊断:扩张型心肌病,心功能Ⅲ级。经强心、扩血管、利尿等处理临床症状缓解,能平卧,呼吸平稳,但心室率仍在90～100次/min。于2月23日8:00加用氨酰心胺12.5mg 口服。11时患者出现头昏,气短乏力,面色苍白,BP:6.67/4kPa(50/30mmHg),HR:35次/min 律齐,两肺呼吸音清晰,立即予多巴胺100mg 加入10%葡萄糖500ml 中静脉滴注,12∶30,血压回
Example 1, male, 56a, repeated palpitation palpitations, chest tightness and urgency 8a, nearly 3mo increased in February 10, 1992 admission. PE: Shenqing, BP: 16 / 10kPa (150 / 75mmHg), sitting breathing, two rales at the bottom of the wet rales, heart left to expand, apex beat A_2, apical scent and Ⅱ / Ⅵ systolic murmur, hepatic ribs 2cm, positive hepatic jugular venous reflux syndrome, both lower extremity concave edema. Clinical diagnosis: dilated cardiomyopathy, cardiac function Ⅲ grade. After cardiac, vasodilator, diuretic and other treatment of clinical symptoms, can be lying, breathing steady, but the ventricular rate is still 90 to 100 beats / min. On February 23 at 8:00 plus ammonia amide 12.5mg orally. At 11:00, the patient developed dizziness, shortness of breath and paleness. The BP: 6.67 / 4kPa (50/30 mmHg), HR: 35 times / min, Qi and breath sounds clearly in both lungs. Immediately, 100 mg of dopamine was added to 500 ml of medium vein Drip, 12:30, blood pressure back