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患者男性,“胸闷、气短10余天,加重伴腹胀1天”入院,心电图及心电监护发现心房颤动伴三度房室传导阻滞,最长R-R间期4.912s。风湿四项、自身抗体、体液免疫、嗜酸性粒细胞、结核杆菌抗体及结核感染T淋巴细胞检测均正常。胸部CT等检查未见明显心包增厚及钙化。心脏超声证实该患者双房显著扩大,双室内径大致正常,左心耳可见中等回声不规则团块;室间隔及左室壁略增厚,心肌光点密集,室间隔运动幅度减低,左室射血分数0.57;未见明显瓣膜病变;心包未见明显增厚钙化,可见少量心包积液。诊断限制型心肌病。行心脏永久性起搏器植入并给予纠正充血性心力衰竭、口服华法林等抗凝药物治疗后,患者症状缓解明显。
Male patients, “chest tightness, shortness of breath more than 10 days, increased with abdominal distension 1 day ” admission, electrocardiogram and ECG monitoring found atrial fibrillation with third degree atrioventricular block, the longest R-R interval 4.912s. Rheumatoid four, autoantibodies, humoral immunity, eosinophils, Mycobacterium tuberculosis antibody and tuberculosis infection T lymphocytes were normal. Chest CT examination showed no obvious pericardial thickening and calcification. Echocardiography confirmed that the patient’s double room significantly expanded, double-chamber diameter is generally normal, the left atrial appendage visible irregular echo mass; ventricular septum and left ventricular wall thickening, myocardial spot density, decreased ventricular septal amplitude, left ventricular injection Blood 0.57; no obvious valvular disease; no obvious calcification of the pericardium, showing a small amount of pericardial effusion. Diagnosis of restricted cardiomyopathy. Permanent cardiac pacemaker implanted and given to correct congestive heart failure, oral warfarin and other anticoagulant therapy, the symptoms were relieved.