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患者,男,76岁。临床诊断:冠心病,慢性左心衰。患冠心病10年,劳累性呼吸困难3年。1年来甚至刷牙时部心悸、气短。半年前Holter监测:窦性心律,完全性左束支阻滞,间歇性交替性三束支阻滞,有2阵房颤,2秒/次,心率150次/min,5秒/次,心率80次/min(图1)。睡眠中发作,无症状。本图是在病人起床后室内散步中突发心悸、气短,迅即端坐呼吸,大汗淋漓,两肺满布湿罗音并掩盖心音。BP13/11kPa。
Patient, male, 76 years old. Clinical diagnosis: coronary heart disease, chronic left heart failure. Coronary heart disease 10 years, tired breathing difficulties for 3 years. 1 year or even brushing his teeth palpitations, shortness of breath. Holter monitoring six months ago: sinus rhythm, complete left bundle branch block, intermittent alternating bundle branch block, 2 atrial fibrillation, 2 seconds / second, heart rate 150 beats / min, 5 seconds / time, heart rate 80 times / min (Figure 1). Attack during sleep, asymptomatic. This picture is a sudden heart palpitations, shortness of breath after walking in the room after the patient gets up, swiftly sitting and breathing, sweating, both lungs covered with moist rales and cover the heart sound. BP13 / 11kPa.