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患者男性,68岁。因心前区疼痛10年,心慌气短4年,加重1周于1991年9月24日入院。查体:体温36.4℃,脉搏108次/分,血压20/12kPa。颈静脉怒张,双肺无罗音。心界不大,心律齐,心率108次/分,无杂音。肝大肋下1.0cm,双下肢有浮肿。心电图Ⅱ、Ⅱ、aVF、V_3、V_5导联ST段下移>0.05mV,V_3、V_5导联T波倒置。X线:心脏呈主动脉型,心胸比值0.50。诊断:冠心病,心衰Ⅲ度。入院后给予巯甲丙脯酸25mg。每日3次口服,1个月后于1991年10月25日晨6时许自觉胸闷明显,听诊心律不齐,强弱
Male patient, 68 years old. Because of heart pain 10 years, palpitation shortness of breath 4 years, an increase of 1 week in September 24, 1991 admission. Physical examination: body temperature 36.4 ℃, pulse 108 beats / min, blood pressure 20 / 12kPa. Jugular vein engorgement, lungs without rales. Heart, heart rate, heart rate 108 beats / min, no noise. Liver big ribs 1.0cm, both lower extremities edema. ST segment of electrocardiogram Ⅱ, Ⅱ, aVF, V_3 and V_5 lead was more than 0.05mV, and T wave of V_3 and V_5 lead was inverted. X-ray: the heart was aortic type, cardiothoracic ratio 0.50. Diagnosis: coronary heart disease, heart failure Ⅲ degree. Admitted captopril 25mg after admission. 3 times a day orally, 1 month after the morning of October 25, 1991 at 6 am conscious chest tightness, auscultation, strength