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病例介绍52岁智力迟钝男性患者,因胸痛第1次入院。6年前诊断为血栓性静脉炎,并开始使用苄丙酮香豆素。入院前2年的1次心电图显示陈旧性前间壁心肌梗塞。入院前7个月因胸前痛就诊,出现进行性运动性呼吸困难,用狄戈辛后症状改善。入院前数天腹围增大,排血便。入院当天胸前痛复发。患者抽烟多年,数量不详。有长期滥饮酒史。体温36.7℃,脉搏120/min,呼吸22/min,血压130/70mmHg。体检:肥胖男性,轻微呼吸困难,有蜘蛛痣。胸部听诊有哮鸣音,双侧肺底有少量啰音。心脏无扩
Case description 52-year-old man with mental retardation, admitted to hospital for chest pain for the first time. Thrombophlebitis was diagnosed 6 years ago and warfarin was started. One electrocardiogram 2 years before admission showed obsolete anterior myocardial infarction. Seven months before admission due to chest pain treatment, progressive exercise dyspnea, with Di Gexin symptoms improved. A few days before admission abdominal circumference increases, bleeding will be. Chest pain recurrence on the day of admission. Patients smoke for many years, the number is unknown. Have a long history of abuse of alcohol. Body temperature 36.7 ℃, pulse 120 / min, breathing 22 / min, blood pressure 130 / 70mmHg. Physical examination: Obese men, slight dyspnea, spider nevus. Auscultation of the chest with wheeze, both sides of the lungs have a small amount of rales. Heart without expansion