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患者男,23岁,农民,素日身体健康,能从事各种体力劳动。于1994年11月2日坐位起立时,突感前胸部剧痛,胸闷、气急、心慌,面色苍白,大汗淋漓,不能平卧,咳嗽吐粉红色泡沫样痰,急往当地医院就诊。按急性心力衰竭给予西地兰、速尿等强心利尿剂及消心痛等血管扩张剂,治疗效果不显,病情日趋加重,于11月12日来我院就诊。当时查体:患者端坐位,颈静脉怒张,面色苍白,口唇紫绀,呼吸急促,BP 13.3/0kPa;双肺满布水泡音,心界向两侧扩大,心尖搏动弥散,胸骨左缘第3、4肋间及心尖区均可触及收缩期震颤,且可闻及粗糙响亮的4/6级以上的占据整个收缩期的连续性喷射性杂音,肺动脉瓣第二音亢进,主动脉听诊区可闻及喷射性喀喇音;腹软,肝肿大,上界右锁骨中线第五肋间右肋下约3cm,剑下约2～
Male patient, 23 years old, peasant, good health day, can engage in a variety of manual labor. On November 2, 1994, standing upright, suddenly broke the chest before the pain, chest tightness, shortness of breath, panic, pale, sweating, can not lie down, cough spit pink foam sputum, and urgently to the local hospital. According to acute heart failure given cedilanid, diuretic and other cardiac diuretics and vasodilators and other vasodilators, the treatment effect is not significant, the condition is aggravating, on November 12 to our hospital. At that time physical examination: patient sitting, jugular vein engorgement, pale, cyanotic lips, shortness of breath, BP 13.3 / 0kPa; lungs covered with blisters sound, the heart bound to both sides of the enlarged apical beating dispersion, , 4 intercostal and apical area can reach systolic tremor, and can be heard and rough loud 4/6 above occupy the entire systolic ejection jet murmur, the second pulmonary hypertrophy pulmonary hypertrophy, aortic auscultation may be Smell and jet Castillo; abdominal soft, hepatomegaly, the upper right subclavian midline of the fifth intercostal right rib about 3cm, under the sword about 2 ~