患者女性,49岁,风湿性心脏病、二尖瓣狭窄伴关闭不全20余年;房颤、心衰10余年,长期口服洋地黄类药物(地高辛0.25mg/日),曾多次住院治疗,心衰可改善。1982年9月10日因发热、胸痛、咳有血丝的粘液样痰而再次入院。体检:T39℃、P约100次/分、BP80/50,神志清,二尖瓣面容,唇绀、颈静脉怒张,左肺闻湿罗音,心律较均齐,P_2↑,心尖部闻及双期杂音。腹软,肝大肋下平脐,质较硬有压痛,脾未及,下肢有凹陷性水肿。胸片示:风湿性心 Patients aged 49, rheumatic heart disease, mitral stenosis with incomplete closure more than 20 years; atrial fibrillation, heart failure more than 10 years, long-term oral digitalis (digoxin 0.25mg / day), has repeatedly hospitalized , Heart failure can be improved. September 10, 1982 due to fever, chest pain, cough with bloodshot mucus-like sputum and re-admitted. Physical examination: T39 ℃, P about 100 beats / min, BP80 / 50, conscious mind, mitral valve surface, cyanotic cyanosis, jugular vein engorgement, left lung smell wet rales, rhythm more uniform Qi, P 2 ↑, apical Ministry Wen And double noise. Abdomen soft, flat umbilical liver ribs, the quality of hard and tenderness, spleen and lower extremity have depression edema. Chest radiograph shows: rheumatic heart