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右旋心是心脏胚胎发育期心脏旋转异常引起的一种先天性畸形,患者心脏呈右位,多合并有心内复杂畸形。本例心脏转位,左右反置但心脏在左侧,心尖指向左侧,各心腔间关系为右旋心右位心的镜中像,称左位心。我院自1956年至今16余万份心电图,仅发现1例,实属罕见。患儿男性,13岁,自幼口唇青紫,活动后紫绀加重。体检:心界向左扩大,心尖搏动位于左第5肋间锁中线外0.5cm,胸骨左缘第3、4肋间闻及Ⅲ—Ⅳ级收缩期杂音,触诊猫颤。X线报告:先天性心脏病,法乐氏五联症,内脏反位。B型超声波示:心脏巨大室间隔缺损,双侧心房心室肥大;肝、脾、肾及大血管左右反位。经右大隐静脉作右心导管检查并经心室造影证实:左右心房心室反位。心电图(附图见第102页)示:
Right-handed heart is a congenital malformation caused by abnormal heart rotation in the heart during embryonic development. The heart of the patient is in the right position, and there are complicated complicated deformities in the heart. In this case, the transposition of the heart, left and right back but the heart on the left, apex pointing to the left, the relationship between the heart chamber right dextrocardia right central mirror like, said the left central position. Our hospital since 1956 so far more than 160,000 ECG, only found in 1 case, it is rare. Children with children, 13 years old, bruising lips, cyanotic increased activity. Physical examination: the heart to the left to expand, apical beats in the left intercostal lock 0.5cm outside the midline, the third intercostal space on the left sternal border 3,4 smell and Ⅲ-Ⅳ systolic murmur palpation of cat flutter. X-ray report: Congenital heart disease, Falin’s pentad, visceral anti-bit. B-mode ultrasound showed: a huge ventricular septal defect, bilateral atrial ventricular hypertrophy; liver, spleen, kidney and left and right anti-bit big vessels. Right saphenous vein for right heart catheterization and confirmed by ventricular angiography: left and right atrial ventricular anti-bit. ECG (with pictures on page 102) shows: