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患者女,43岁。有活动后心慌、气短史15年。因突然出现严重心慌、气短10天,于1986年3月21日转来本院。曾于当地医院住院诊断为“充血性心肌病、心动过速”,经用地高辛、普鲁卡因酰胺及心得安等药物治疗无效。入院检查:重病容,心率180次/min,血压13.3/9.33kPa(100/70mmHg)。心界扩大、心音低钝、律整。心电图:各导联无P波,QRS波呈宽大畸形,R一R间隔略不等。食管导联心电图显示每隔一宽大QRS波前约0.08s可见一逆行双相P波,P-R间期为0.16s,心电图诊断为室性心动过速伴2∶1室房传导。当晚以150J行同步电转复未成功,改用乙胺碘呋酮0.2g一日三次口服。
Female patient, 43 years old. After activities palpitation, shortness of breath 15 years. Due to a sudden severe palpitation, shortness of breath for 10 days, on March 21, 1986 transferred to the hospital. Was hospitalized in a local hospital diagnosed as “congestive cardiomyopathy, tachycardia,” with digoxin, procainamide and propranolol and other drugs ineffective treatment. Admission examination: seriously ill, heart rate 180 beats / min, blood pressure 13.3 / 9.33kPa (100 / 70mmHg). Expand the heart, low heart sound blunt, rhythm. ECG: the P lead no lead, QRS wave was large deformity, R-R interval slightly ranging. The esophageal lead ECG showed a biphasic P-wave retrograde with a P-R interval of about 0.08 s for every one large QRS wavefront, with a P-R interval of 0.16 s. ECG was diagnosed as ventricular tachycardia with 2: 1 ventricular conduction. The night of 150J line synchronization recovery was unsuccessful, changed to amiodarone 0.2g three times a day orally.