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诊断病史近1~2周内曾有过病毒感染(包括亚临床感染)、感冒、发热、上呼吸道感染、扁桃体炎、原因不明之腹泻及其他病毒性疾病的病史,并能排除细菌、霉菌、原虫等感染者而出现胸痛、气急、心悸和虚脱等症状.体检①持续性心动过速(与体温不成比例)伴有低血压,或突然出现严重的心动过缓。②第一心音减弱。③房性或室性奔马律.④心脏扩大或有心力衰竭。⑤既往心脏无杂音而突然出现杂音者.⑥突然的心电图改变:有较严重的心律失常.其他诊断可根据 X 线检查、心电图、病毒分离心肌活检、血清学检查等项.鉴别诊断一、与风湿性心肌炎鉴别:1、杂音:①二尖瓣区回流性杂音:虽病毒性和风湿性心肌炎都可听到二尖瓣回流杂音,但病毒性心肌炎,则需心脏明显增大后才能闻及.其产生
History of diagnosis During the past 1-2 weeks there have been a history of viral infections (including subclinical infections), colds, fever, upper respiratory tract infections, tonsillitis, unexplained diarrhea and other viral diseases and to exclude bacteria, molds, Protozoa and other infections and chest pain, shortness of breath, palpitations and prostration and other symptoms. Physical examination ① persistent tachycardia (with disproportionate body temperature) associated with hypotension, or sudden severe bradycardia. ② first heart sound weakened. ③ atrial or ventricular gallop.④ heart enlargement or heart failure. ⑤ no noise in the past the sudden emergence of murmurs. ⑥ sudden ECG changes: more serious arrhythmia. Other diagnosis based on X-ray examination, ECG, virus isolation myocardial biopsy, serological tests, etc. Differential diagnosis A Identification of rheumatic myocarditis: 1, noise: ① mitral regurgitation murmur: Although both viral and rheumatic myocarditis can hear mitral regurgitation murmur, but viral myocarditis, you need to significantly increase the heart before you can smell It produced