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患者男性,21岁。二个月前左胸部被汽车撞伤,当即医院检查并诊断为“左胸壁挫伤”,同时发现心脏有杂音。以后在劳累后觉胸前区涨闷,心慌气短,门诊以“先天性室间隔缺损”收住院。追问病史,即往身体健康,幼时曾患“气管炎”,在升学及招工体检中均未发现心脏有杂音,平时也无劳累后心悸气短、口唇发绀现象,不喜蹲距。体检:T36.8℃,P84次/分,BP124/80mmHg。无颈静脉怒涨,心界不大,胸骨左缘第三、四肋间可闻Ⅲ级收缩期杂音并向腋下传导,伴有震颤,肺动脉第二音不亢进,余征(一)。心电图:窦性心律,ⅡⅢ、αVF导联出现深窄的Q波和高而尖的T波。胸部X光片:双肺血增多,心脏呈二
Patient male, 21 years old. The left chest was bruised by a car two months ago. Immediately the hospital examined and diagnosed as “contusion of the left chest wall” and at the same time found a heart murmur. Later in the chest after feeling tired upset, palpitation shortness of breath, clinic to “congenital ventricular septal defect” admitted to hospital. Asked history, that is, to physical health, childhood suffering from “bronchitis”, in the study and recruitment of physical examination were found no heart murmur, usually without fatigue, palpitations shortness of breath, lips cyanosis, dislike squat distance. Physical examination: T36.8 ℃, P84 times / min, BP124 / 80mmHg. No jugular vein anger, the heart is not large, the left sternal third, intercostal can be heard Ⅲ systolic murmur and conduction to the armpit, accompanied by tremor, pulmonary artery second tone is not hyperthyroidism, Yu Zheng (a). Electrocardiogram: sinus rhythm, Ⅱ Ⅲ, αVF lead appears deep narrow Q wave and high and sharp T wave. Chest X-ray: double lung blood increased, the heart was two