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临床资料患者,男,13岁,26 kg。因发现心脏杂音5年入院。平时易患上呼吸道感染,发育较同龄人差,活动后偶感心累、气促等不适;无呼吸困难、紫绀、蹲踞、杵状指等。查体:身材矮小,发育较差,心前区无隆起,心前区可触及细震颤,心浊音界略向右侧扩大,胸骨左缘第3~4肋间可闻及3/6~4/6级全收缩期杂音,粗糙,向右侧传导。心电图示:不完全性右束支传导阻滞。胸部X线片示:心影稍增大。心脏彩色超声心动图提示(图1):左右心室稍增大,主动脉窦部稍增宽,主动脉升部正常;室间隔嵴下膜部(大动脉短轴切面约10点钟
Clinical data Patient, male, 13 years old, 26 kg. 5 years due to heart murmur admitted to hospital. Normally susceptible to upper respiratory tract infection, poor development than their peers, after the event even feeling tired, shortness of breath and other discomfort; no breathing difficulties, cyanosis, squatting, clubbing and so on. Physical examination: short stature, poor development, no anterior bulging area, precordial area can reach the fine tremor, the heart of the voiced sound sector to the right to expand the sternal left margin of the intercostal 3 to 4 and 3/6 to 4 / 6 full systolic murmur, rough, to the right conduction. ECG shows: incomplete right bundle branch block. Chest X-ray film shows: slightly increased heart shadow. Heart color echocardiography (Figure 1): left and right ventricular slightly increased, aortic sinus slightly widened, aortic ascending normal; intercostal space under the ridge (short axis of the aorta about 10 o’clock