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患者女性,19岁,因心悸、胸闷6天,晕厥1次入院。半月前曾发热、流涕和咳嗽3天。体检:T37.3℃,R18次/分,BP90/40。两肺呼吸音清,心率约48次/分,律不齐,各瓣膜区无病理性杂音。血钾4.7mmol/L,血沉23mm/小时。临床诊断:病毒性心肌炎;病态窦房结综合征。附图(见第170页)为入院时心电图Ⅰ、Ⅲ导联,图中长P-P间距与短P-P间距之差大于0.16秒,存在窦性心律不齐,P波频率约54次/分。Ⅰ导联P_3-P_4、Ⅲ导联P_4-P_5间距等于基本心律的2倍,为Ⅱ°窦房传导阻滞。Ⅰ导联中R_4提前出现,QRS波形态正常,其前存在窦性P波,P-R间期0.16秒,为心室夺获。其
Female patient, 19 years old, due to heart palpitations, chest tightness 6 days, syncope 1 admission. Half a month ago fever, runny nose and cough for 3 days. Physical examination: T37.3 ℃, R18 beats / min, BP90 / 40. Respiratory sound clear lungs, heart rate about 48 beats / min, irregular arrhythmia, the valve area without pathological murmur. Potassium 4.7mmol / L, ESR 23mm / hour. Clinical diagnosis: viral myocarditis; sick sinus syndrome. The figure (see page 170) is the ECG leads I and III on admission. The difference between the long P-P spacing and the short P-P spacing is greater than 0.16 seconds. There is sinus arrhythmia and the P-wave frequency is about 54 beats / min. Ⅰ lead P_3-P_4, Ⅲ lead P_4-P_5 pitch is equal to 2 times the basic rhythm, Ⅱ ° sinoatrial block. Ⅰ lead appears in advance of R_4, QRS wave morphology is normal, the presence of sinus P wave before, P-R interval of 0.16 seconds for the ventricular seizure. its