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患者,男,34岁。因过度劳累当夜睡眠中突发心前区窒息性疼痛,伴出汗、心悸、气急,无放射痛,数分钟后症状自行缓解,次日急诊入院。3年前有类似发作史一次,疼痛持续达2h之久。入院体检:体温36.5℃,脉搏66次,呼吸19次,血压14/8kPa,心尖搏动在胸骨左侧第五肋间锁骨中线外2Cm处,心浊音界向左下扩大,心尖区可闻及Ⅲ～Ⅳ级收缩期吹风样杂音,粗糙,向左腋下传导。血糖6.0mmol/L,胆固醇8.8mmol/L,β—脂蛋白4.8g/L白细胞7.8×10~9/L, 抗O 256U,血沉12mm/h。心脏X线片示心脏向左下扩大,心尖上方左心缘可见局限性膨出,左侧位片见左心缘上方局限性膨出。透视见左心
Patient, male, 34 years old. Due to over-exertion in the night sleep sudden precordial asphyxia, accompanied by sweating, heart palpitations, shortness of breath, no radiating pain, symptoms relieved a few minutes later, emergency admission the next day. 3 years ago, a history of similar attacks once, the pain lasts up to 2h. Admission physical examination: body temperature 36.5 ℃, pulse 66 times, breathing 19 times, blood pressure 14 / 8kPa, apical beating in the left sternal fifth intercostal clavicle midline 2Cm Department of heart and voiced sound to the lower left, apical area can be heard and Ⅲ ~ Ⅳ grade systolic hair-like noise, rough, left axillary conduction. Blood glucose 6.0mmol / L, cholesterol 8.8mmol / L, β-lipoprotein 4.8g / L white blood cells 7.8 × 10 ~ 9 / L, anti O 256U, ESR 12mm / h. Cardiac X-ray shows the heart to the left to expand the left apex of the top of the apex can be seen limited bulging, the left side of the left ventricle to see the top of the limitations of bulging. See the left heart perspective