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患者女性,67岁,因发作性心悸、气短、浮肿20余年、近日加重入院。有不洁性交史。体检:心界向左下扩大,心尖搏动明显,呈抬举样,胸骨左缘第3、4肋间有一来往性收缩期及舒张期吹风样杂音。入院时心电图示窦性心律、电轴左偏、完全性左束支传导阻滞、左室肥厚劳损和频发房性早搏。超声切面显像:升主动脉呈局限性增宽,内径4.2cm,管壁僵硬,主动脉瓣反射明显增强,活动受限,全心扩大以左室为主。血清华、康氏反应阳性,临床诊断:梅毒性心脏病,主动脉瓣狭窄及关闭不全,心衰Ⅲ度。
Female patients, 67 years old, due to episodes of heart palpitations, shortness of breath, edema more than 20 years, recently increased admission. Have a dirty sex history. Physical examination: heart to expand to the left, apical beating was obvious, was lift like, left and right sternal intercostal 3,4 and a systolic and diastolic hair-like noise. ECG on admission showed sinus rhythm, left axis deviation, complete left bundle branch block, left ventricular hypertrophy and frequent atrial premature beats. Ultrasound section imaging: Ascending aorta was localized widened, diameter 4.2cm, wall stiffness, aortic valve reflex was significantly enhanced, limited mobility, heart widened to the left ventricle. Serum Hua, Kang positive reaction, clinical diagnosis: syphilitic heart disease, aortic stenosis and insufficiency, heart failure Ⅲ degree.