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自发性心脏腱索断裂起病突然,病情凶险多变。我院近年误诊2例,报告如下。例1;男,58岁。反复胸闷、气喘、不能平卧,两年内3次住院。既往有一期矽肺病史10年,三年前测血压高于正常,其后多次测血压正常。前两次住院均诊断为高血压性心脏病合并冠心病、肺心病。1989年8月23日第三次入院。查体:发育营养正常,口唇紫绀,两下肺少许湿罗音。心界增大,心率84次/分,心律绝对不齐。心尖区持续性收缩期杂音Ⅳ级,向左腋下传导,伴心尖区震颤。血脂分析及血糖均正常。心电图示心房颤动。胸片:左室、左房、右室、增大,以左室增大为主,两肺野纹理增多,肺门影增浓扩大,结构紊乱。超声心动图(美国 HP77020—AC 型):全心扩大,二尖瓣前
Spontaneous heart chordae rupture suddenly, the disease dangerous and changeable. My courtyard misdiagnosed in 2 cases in recent years, the report is as follows. Example 1; male, 58 years old. Repeated chest tightness, asthma, can not lie down, three times within two years of hospitalization. Past history of a silicosis 10 years, three years ago, higher than normal blood pressure test, followed by repeated measurements of blood pressure normal. The first two hospitalizations were diagnosed as hypertensive heart disease with coronary heart disease, pulmonary heart disease. August 23, 1989 the third admission. Physical examination: normal developmental nutrition, cyanosis of the lips, two lungs a little wet rales. Heart increased, heart rate 84 beats / min, heart rate is absolutely missing. Apical persistent systolic murmur Ⅳ, left axillary conduction, with apical tremor. Lipid analysis and blood glucose were normal. ECG shows atrial fibrillation. X-ray: left ventricle, left atrium, right ventricle, increased to the left ventricular enlargement mainly increased the two lung field texture, enlarged hilar shadow enlargement, structural disorders. Echocardiography (US HP77020-AC type): total heart enlargement, mitral valve anterior