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患者男,38岁。诉活动后心慌气急1年余。1984年曾出现劳力性呼吸困难及夜间阵发性呼吸困难,井发现心脏有杂音。于1985年12月21日心电图示前壁心肌梗塞急诊入院。否认有心绞痛及晕厥史。有“高血压病史”,收缩压波动在180～190mmHg,舒张压不详。 体检:T36.8℃,P100次/分,R30次/分,BP230/50mmHg。神志清醒,急性重病容,端坐呼吸,皮肤冰冷潮湿。可见明显颈动脉搏动及颈静脉怒张。心尖搏动明显向左下移位,呈抬举性搏动,
Male patient, 38 years old. Frustration after vowing activity more than 1 year. In 1984 there was exertional dyspnea and paroxysmal nocturnal dyspnea, and we found a heart murmur. December 21, 1985 ECG showed anterior myocardial infarction emergency admission. Denied angina and history of syncope. A “history of hypertension,” systolic blood pressure fluctuations in the 180 ~ 190mmHg, diastolic pressure is unknown. Physical examination: T36.8 ℃, P100 beats / min, R30 beats / min, BP230 / 50mmHg. Conscious, acute and serious illness, sitting and breathing, cold and wet skin. Visible carotid artery pulse and jugular vein engorgement. Apex beating significantly shifted to the left, was beating the beating,