论文部分内容阅读
患者女性,72岁。反复发作性心动过速20年。因心动过速发作5h,内服丙胺苯丙酮450mg,突然晕厥急诊入院。体检:BP70/50mmHg(9.3/6.7kPa),神志清,肢冷,脉搏不清。心界不大,心率40次/min,律齐,未闻杂音。肝肾功能、血清电解质正常,胸片、二维超声心动图无异常。入院时心电图(附图上行Ⅱ)示窦性停搏,房室交界区逸搏心律,R-R 间距1.36s,P 波在Ⅱ、Ⅲ、aVF 及胸导联呈正相,位于 QRS 波之后R-P 间期固定为0.12s。静注阿托品即时(上行V_6)R-R 间距缩短至1.18s 时,R-P 间期仍为0.
Patient female, 72 years old. Recurrent tachycardia for 20 years. Due to the onset of tachycardia 5h, oral propanopril 450mg, sudden syncope emergency admission. Physical examination: BP70 / 50mmHg (9.3 / 6.7kPa), conscious mind, cold limbs, pulse is not clear. Heart, heart rate 40 times / min, law Qi, no unheard noise. Liver and kidney function, normal serum electrolytes, chest X-ray, two-dimensional echocardiography no abnormalities. On admission, the electrocardiogram (top Ⅱ in the figure) showed sinus arrest, atrial rhythm of atrioventricular junctional escape, RR interval 1.36s, P wave positive in phase Ⅱ, Ⅲ, aVF and chest lead, located in RP interval after QRS wave Fixed at 0.12s. Intravenous atropine immediate (uplink V_6) R-R spacing is shortened to 1.18s, the R-P interval is still 0.