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患者男性,74岁。10年前因头晕在当地乡医院就诊,诊断为高血压病。近1年来,经常头晕.心慌.心前区不适,加重1月余,并出现气急.下肢浮肿.平卧或活动后更甚。因两天前晕倒、抽搐一次入院。查体:坐位时颈静脉充盈。心率40/min,呼吸24/min。第一心音弱,无杂音,律齐。背部两肺底有小水泡音。肝大肋下3cm,有压痛。双下肢浮肿。血压:26.7/13.3 kPa(200/100mmHg)。X 线心脏三位片:主动脉增宽,迂曲延长,左心室增大,心影呈主动脉型。心肌酶正常。临床诊断:高血压性心脏病伴阿-斯综合征,心功能4级。
Male patient, 74 years old. 10 years ago due to dizziness in the local township hospital, diagnosis of hypertension. Nearly a year, often dizzy. Flustered. Prei area discomfort, more than 1 month, and there is shortness of breath. Lower limb edema. After supine or even more activities. Fainted two days ago, convulsions once admitted. Physical examination: sitting jugular vein filling. Heart rate 40 / min, breathing 24 / min. First heart sound weak, no noise, law Qi. Back of the two lungs with a small blisters sound. Liver ribs 3cm, tenderness. Lower extremity edema. Blood pressure: 26.7 / 13.3 kPa (200/100 mmHg). X-ray three tablets: aorta broadening, prolonged tortuous, left ventricular enlargement, aortic heart profiling. Myocardial enzymes normal. Clinical diagnosis: hypertensive heart disease with Asperis syndrome, cardiac function 4.