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患者男性,67岁,因反复头昏17年,劳力性心慌气促3月于1999年3月19日10点入院.入院前2天门诊EKG示频发多源性交界性早搏,左室高电压,拟“高血压性心脏病伴心律失常”予慢心律0.2 g,1日3次,ATP 20 mg,1日3次治疗,症状无减来诊.查体:血压180/90 mmHg,慢性病容,双眼角膜缘未见老年环.心脏向左轻度扩大,心率76次/分,早搏8～10次/分,心音有力,各瓣膜听诊区未闻及杂音.肝脾肋下未及,双下肢不肿.实验室检查:血糖、血脂、电解质正常.多普勒超声:左室稍扩大(56 mm),左室假腱索.X线胸片:主动脉扭曲,心影呈主动脉型,左心缘丰满.EKG示频发多源交界性早搏,左室高电压,T波改变.入院诊断:原发性高血压(Ⅲ期),高血压性心脏病,心脏扩大,心功能Ⅱ级,心律失常.入院后用心律平(江
Patients, male, 67 years old, due to repeated dizziness 17 years, exertional palpitation and shortness of breath March was admitted at 10:00 on March 19, 1999. Two days before admission, EKG showed frequent borderline premature beats, Voltage, proposed “hypertensive heart disease with arrhythmia” to slow heart rate 0.2 g, 3 times on the 1st, ATP 20 mg, 3 times on the 1st treatment, no symptoms to reduce the number of visits. Physical examination: blood pressure 180/90 mmHg, chronic disease Volume, both limbal limbal ring was not seen.The heart slightly expanded to the left, heart rate 76 beats / min, premature beats 8 to 10 beats / min, strong heart sounds, the valve auscultation area did not smell and noise.Healthy spleen and ribs, Laboratory examination: blood glucose, blood lipids, electrolytes normal Doppler ultrasound: slightly enlarged left ventricle (56 mm), left ventricular false tendons cable X-ray: aortic distortion, aortic heart shadow Type, the left heart margin plump .EKG showed frequent multi-source borderline premature beats, left ventricular high voltage, T wave changes.Admission diagnosis: essential hypertension (hypertension), hypertensive heart disease, cardiac enlargement, cardiac function Ⅱ level, arrhythmia. After admission with heart rhythm (Jiang