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急性心肌梗塞(简称 AMI)并发室间隔穿孔,如能早期做出诊断,及时防治泵衰、心律失常,以及择期手术可提高存活率。例1:女,70岁。主因阵发性心前区疼痛一年,心悸气短三天,在某医院诊断为 AMI,病历记录心脏无杂音。患者在转我院途中症状加重。既往有高血压病史。查体:血压90/60mmHg,颈静脉怒张,双肺底可闻湿性罗音。心界向左扩大,心率120次/分,律齐,胸骨左缘第4、5肋间隙可听到4/6级收缩期杂音,伴震颤,杂音不向左腋下传导。肝在肋下2cm,肝颈静脉逆流征阳性,下肢有指凹性水肿。心电图示:Qv_1—v_3、Ⅱ、Ⅲ、aVF,伴
Acute myocardial infarction (AMI) complicated by interventricular septum perforation, if early diagnosis, timely prevention and treatment of pump failure, arrhythmia, and elective surgery can improve survival. Example 1: Female, 70 years old. Mainly due to paroxysmal atrial pain a year, palpitations shortness of breath for three days, in a hospital diagnosis of AMI, medical records without heart murmur. Patients in the transfer of symptoms on the way to our hospital. Past history of hypertension. Physical examination: blood pressure 90 / 60mmHg, jugular vein engorgement, both lungs can be heard wet rales. Heart to the left to expand the heart rate 120 beats / min, law Qi, the left margin of the 4th intercostal space 4 to 6 systolic murmur can be heard, with tremor, murmur not left axillary conduction. Liver in the ribs 2cm, liver jugular vein reflux positive, lower extremity have concave edema. ECG shows: Qv_1-v_3, Ⅱ, Ⅲ, aVF, with