患者男,64岁,主因“反复发作性胸闷气短半年”入院。既往否认高血压、高脂血症、糖尿病史,无明确心前区疼痛及急性心肌梗塞病史,有少量烟酒史。半年来,多于劳累后出现胸闷气短,持续3～10分钟,休息后可缓解。近1个月病情加重,出现呼吸困难,夜晚不能平卧及双下肢水肿。查体:血压19/11 kPa,半卧位,口唇紫绀,颈静脉充盈,心界扩大,心率110次/分,律齐,心尖部闻及Ⅱ级收缩期吹风样杂音。腹软,肝脾肋下未触及。双下肢轻度水肿。心电图:窦性心律,阵发性房颤,偶发室早,电轴 Male patient, 64 years old, mainly due to “recurrent chest tightness, shortness of breath,” admitted to hospital. Previously denied high blood pressure, hyperlipidemia, history of diabetes, no clear precordial pain and acute myocardial infarction history, a small amount of alcohol and tobacco history. Six months, more than tired after chest tightness, shortness of breath, sustained 3 to 10 minutes after the rest can be alleviated. Nearly one month the condition worsened, breathing difficulties, night can not lie and edema of both lower extremities. Physical examination: blood pressure 19/11 kPa, semi-recumbent position, cyanosis of the lips, filling of the jugular vein, heart expansion, heart rate 110 beats / min, law Qi, apical Ministry smell and Ⅱ grade systolic hair-like murmur. Abdominal soft, liver and spleen ribs did not touch. Lower extremity mild edema. Electrocardiogram: sinus rhythm, paroxysmal atrial fibrillation, occasional premature ventricular axis