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患者男、52岁,因“发作性心悸半小时”入院。入院前无心悸、胸闷、胸痛、黑蒙、晕厥等症状,无高血压及糖尿病病史。查体:血压110/80mmHg,双肺未闻及干湿性罗音,叩诊心界不大,心率:76bpm,律不齐。心肌损伤标记物、电解质正常。心电图示:窦性心动过缓,房性早搏,心动过速发作时P波不清楚,QRS波时限增宽,V4～V6导联起始部q波消失呈左束支阻滞图形(图略),考虑为起源于右室的室速(图1),立即给予利多卡因抗心律失常治疗,心动过速发作减少,停药后心动过速发作增多,给予胺碘酮抗心律失常亦有效。
Male patient, 52 years old, was admitted for “onset of palpitation for half an hour.” Before admission, no heart palpitations, chest tightness, chest pain, dark, fainting and other symptoms, no history of hypertension and diabetes. Examination: blood pressure 110 / 80mmHg, unhealthy lungs and wet and dry rales, percussion little heart, heart rate: 76bpm, irregularities. Myocardial injury markers, electrolyte normal. ECG shows: sinus bradycardia, atrial premature beat, tachycardia P wave is not clear, QRS wave duration widening, V4 ~ V6 lead q wave disappeared was left bundle branch block pattern (Figure omitted ), Considered ventricular-derived VT (Figure 1), immediately given lidocaine anti-arrhythmia treatment, reduced tachycardia, withdrawal after tachycardia increased, given amiodarone anti-arrhythmia also effective .