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例1男,61岁。因夜间睡眠时突感心前区剧烈疼痛伴大汗,含化硝酸甘油不缓解而入院。既往曾多次做二维超声心动图及彩色多普勒检查,明确诊断为风湿性心瓣膜病,二尖瓣及主动脉瓣均有狭窄及关闭不全;无高血压及冠心病史。查体:T35.8℃,BP17.3/10.3kPa。神清,消瘦,两肺少许干鸣音。心律绝对不整,二尖瓣及主动脉瓣听诊区均可闻及双期杂音。肝脾不大,双下肢无浮肿。心电图示心房纤颤(Af),Ⅱ度房室传导阻滞:S—T段ⅡⅢavF抬高0.2～0.45mv,avL.V_2～V_5下移0.2～0.4my。血沉5mm/h,Hb151g/L。入院后按急性心梗处理。追踪心电图有AmⅠ典型演变过程,提示下壁心梗。6周后痊愈出院。例2男,61岁。因心前区疼痛3天余,突有加重伴大汗而入院。既往有风心病史10余年、无高血压及冠心病史。查体:T36.2℃,P94次/min,BP18/8kPa,
Example 1 Male, 61 years old. Because of sudden nocturnal pain during sleep at night with severe pain with sweating, nitroglycerin-containing without remission and admission. Previously, many times to do two-dimensional echocardiography and color Doppler examination, a clear diagnosis of rheumatic heart disease, mitral and aortic valve are stenosis and insufficiency; no history of hypertension and coronary heart disease. Physical examination: T35.8 ℃, BP17.3 / 10.3kPa. God clear, weight loss, lungs a little dry sounds. Absolute heart rhythm, mitral and aortic valve auscultation area can be heard and double noise. Liver and spleen is not large, no swelling of both lower extremities. ECG showed atrial fibrillation (Af), Ⅱ degree atrioventricular block: S-T segment Ⅱ Ⅲ avF elevation 0.2 ~ 0.45mv, avL.V_2 ~ V_5 down 0.2 ~ 0.4my. ESR 5mm / h, Hb151g / L. After admission by acute myocardial infarction. Tracing the electrocardiogram has a typical evolution of AmI, suggesting inferior myocardial infarction. He was discharged after 6 weeks. Example 2 Male, 61 years old. Due to precordial pain more than 3 days, suddenly aggravated with sweat and admitted to hospital. Past history of rheumatic heart disease more than 10 years, no history of hypertension and coronary heart disease. Physical examination: T36.2 ℃, P94 times / min, BP18 / 8kPa,