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1诊断及其依据1.1心力衰竭、心功能Ⅳ级伴左心室长大、心动过速、肺水肿、胸腔积液。依据:患者有咳嗽、心累、气紧、呼吸困难、不能平卧等症状;查体心率增快,双下肺闻及明显湿啰音。辅助检查:血气分析示PO2、SpO2低;胸部B超示胸腔积液;X线示心影增大,心尖左下移位,双上肺静脉增粗,肺门增大、模糊;心脏彩超提示左室增大、左室收缩功能降低。导致患者出现上述心脏改变的原因尚不明确,考虑系围生期心肌病,但仍不能排除心肌炎、甲亢、妊娠期高血压疾病等可能。
1 diagnosis and its basis 1.1 heart failure, heart function Ⅳ grade with left ventricular hypertrophy, tachycardia, pulmonary edema, pleural effusion. Based on: the patient has cough, tired heart, tightness, difficulty breathing, can not lie and other symptoms; physical examination heart rate increased, double lung smear and obvious wet rales. Auxiliary examination: blood gas analysis showed PO2, SpO2 low; chest B ultrasound showed pleural effusion; X-ray showed increased cardiac, apical lower left shift, double pulmonary vein thickening, hilar enlargement, blurred; Increase, reduce left ventricular systolic function. Cause of the patient appears the heart of the reasons for the change is not clear, consider perinatal cardiomyopathy, but still can not rule out myocarditis, hyperthyroidism, gestational hypertension and other possible.