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患者女性,50岁。因胸痛、恶心、呕吐入院。16年前患甲亢,曾住院治疗,其后在门诊口服他巴唑,2年后因出现皮诊,自行停药。5年来活动时疲乏无力,2、3年来,不论活动或休息时均可发生背痛彻胸之疼痛感,每年发作数次,但安静休息即好转,故未介意。2年前的一天,早晨起床时即感乏力比往日重,午饭后发生剧烈胸痛,伴恶心呕吐,疼痛持续30分钟以上,因出现休克症状而住院。收缩压在80～100mmHg间波动,脉搏80次/分,脉律不整,有时出现室性期前收缩,查体:心肺正常,肝肋下3～4横指,下肢浮肿。第4天GOT222、GPT167单位。第5天体温37.5℃,此后渐降至正常。第6天LDH1,267单位,T_418.2微克%,T_3RSU(树脂海绵摄取量)56.3%,白细胞12,700/mm~3,CRP(++)。发作时心电图示ST?)显著升高,ST_Ⅰ、aVR、aVL、V_1-V_6显著压低,R_1明显
Female patient, 50 years old. Due to chest pain, nausea, vomiting admitted to hospital. 16 years ago suffering from hyperthyroidism, had hospitalized, then oral methimazole in the clinic, 2 years after the emergence of a diagnosis, self-withdrawal. 5 years of activity when tired, 2 or 3 years, regardless of activity or rest can occur when chest pain pain, attack several times a year, but the quiet rest that is better, so do not mind. One day two years ago, when I got up in the morning, I felt more tired than I used to. I had severe chest pain after lunch, accompanied by nausea and vomiting. The pain lasted over 30 minutes and was hospitalized due to shock symptoms. Systolic blood pressure fluctuations in the 80 ~ 100mmHg, pulse 80 beats / min, irregular pulse, and sometimes ventricular contractions, physical examination: normal heart and lungs, liver ribs 3 to 4 transverse means, lower extremity edema. Day 4 GOT222, GPT167 units. The fifth day body temperature 37.5 ℃, then gradually decreased to normal. On the 6th day LDH1,267 units, T_418.2 micrograms%, T_3RSU (resin sponge uptake) 56.3%, leukocytes 12,700 / mm ~ 3, CRP (++). ST? I, aVR, aVL, V_1-V_6 significantly decreased, R_1 significantly