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李云青 《临床心血管病杂志》1988,(2)
患者,女,68岁。约30岁开始手足变粗短,颜面逐渐丑陋,视力下降,劳力减弱,未能生育。平时血压正常,无心绞痛病史。1984年10月5日下午6时许突感呼吸困难,剧烈咳嗽伴头痛,急诊入院。体检:T 38.6℃,BP240/150mmHg 典型肢端肥大症外貌,神志昏迷,重度紫绀,口鼻涌出大量粉红 相似文献
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肢端肥大症性心肌病2例 总被引:4,自引:0,他引:4
例 1 女 ,43岁。发现颜面发育异常 1 0余年 ,反复胸闷、气短伴双下肢水肿 1年 ,加重 3d入院。1年前发现“垂体瘤”,未治疗。 3年前闭经。入院时体检 :血压 ( BP) 1 2 0 /70 mm Hg( 1 mm Hg=0 .1 33k Pa) ,端坐呼吸 ,皮肤粗糙 ,多汗、多毛。前额骨、眉弓、颧骨弓及鼻增大、突出 ,左眼失明 ,口唇增厚 ,舌大而厚 ,语音低顿。双侧颈静脉怒张 ,双肺底细小水泡音 ,心尖搏动于 肋间左锁骨中线外 3.0 cm,心率 1 0 2次 /min,律不齐 ,心尖部 级收缩期吹风样杂音。肝大肋下 4.0 cm,双下肢重度水肿。超声心动图示左室 ( LV) 70 mm,左房 ( LA) 55m… 相似文献
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《中西医结合心脑血管病杂志》2020,(14)
正1 资料病人,男,33岁,因反复胸闷、憋喘半年余,加重3 d入院。病人诉近半年来,小于日常体力活动时出现胸闷、憋喘不适,无胸痛、放射痛,无咳嗽、咳痰,无心悸、出汗,无呼吸困难、发绀、蹲踞现象,休息数分钟可缓解,未予以重视,此后逐渐出现静息状态下的胸闷、憋喘,遂就诊于当地医院,心脏超声提示:左室舒张内径71 mm,左房前后径35 mm,左室顺应性减低,二尖瓣、三尖瓣关闭不全(轻度);心电图提示:窦性心动过速,心率113次/min,偶 相似文献
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1临床资料
男性患者,45岁。因活动后气促、喘憋2个月,加重2周入院。患者2个月前出现活动后气促、喘憋,当地医院心脏超声心动图示:全心弥漫性扩大,二尖瓣大量返流,左室射血分数(EF)20%,诊断为扩张性心肌病。近2周患者喘憋阵发加重,夜间不能平卧,于当地医院经抗心力衰竭治疗后症状缓解不明显,为求进一步诊治转入我院。既往无高血压、冠心病、瓣膜性心脏病及心肌炎病史,无嗜酒。入院查体:血压105/60mmHg(1mmHg=0.133kPa),呼吸22次/min,神志清,端坐位,皮肤粗糙,唇略发绀、增厚,耳鼻及下颌增大,颧弓突出,眉弓高,四肢指(趾)间关节短粗;双肺底可闻及少量小水泡音;心界向左扩大,心率89次/min,早搏3~6次/min,心尖部可闻及3/6级收缩期杂音,向腋下、后背部传导。 相似文献
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1 临床资料患者男 ,78岁。因阵发性胸闷 12年 ,加重 12d于 2 0 0 2年 8月 12日入院。 1985年患垂体瘤 (泌乳素和生长激素混合细胞腺瘤 ) ,肢端肥大症 ,长期口服“溴隐亭” ,泌乳素控制在正常范围内 ,但自 1985年患病至 2 0 0 2年 3月生长激素为1.2 0~ 2 1.4 0nmol L(正常范围 :0 .0 1~ 0 .2 1nmol L)。 1991年因冠心病 ,2 0 0 0年又因病窦综合征安装VVI型心脏起搏器 ,无糖尿病、高血压病史。体检 :眉弓高 ,鼻大、唇厚 ,心界向两侧扩大 ,心率 5 5次 min ,律齐 ,听诊主动脉瓣第二区闻及 3 6级收缩期吹风样及舒张期隆隆样杂音 ,二尖瓣区闻… 相似文献
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男患,37岁。于12年前开始出现手、足进行性增大,伴有多汁、体毛增多,近2年有明显心慌、气短,活动后加重,不能平卧,但无咳嗽、咯血及浮肿史。经当地医院诊断为扩张型心肌病,曾用速尿、西地兰、 相似文献
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肢端肥大症在临床上并非罕见,但并发肥厚型心肌病报道较少,笔者就本院所诊治的2例报道如下。例1男,68岁。因反复胸闷、气喘11年加重1d拟“急性左心衰竭”收入院。经询问病史,患者自幼逐渐出现股端粗大,并反复胸闷、气喘。入院体检:心浊音界向左下扩大,HR110次/min,律齐,心尖部及主动脉瓣区闻及皿级收缩期杂音,BP22/13kPa。实验室检查:血生长激素(HGH)31.68ng/ml.ECG:I、aVL、V5、V6异常Q波。UCG:左房舒张末期内径4.60cm、左室舒张未期内径5.30~5.50cm,在室壁显著增厚(IVS2.70cm、LVPW2.50cm),室间… 相似文献
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S Arvan 《American heart journal》1986,111(3):603-604
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A.J. Buda D.L. Levene M.G. Myers A.W. Chisholm S.J. Shane 《American heart journal》1978,95(4):457-462
Ten patients, representing 1.34 per cent of those patients undergoing selective coronary arteriography, were found to have unequivocal evidence of coronary artery spasm. This involved the proximal right coronary artery in eight patients, the mid-left anterior descending branch in one, and the left main coronary artery in one. Eight of these 10 patients had otherwise normal coronary arteries.Of these 10 patients with coronary artery spasm, nine had evidence of mitral valve prolapse. This involved the posteromedial scallop in six patients; the anterolateral and posteromedial scallops in one; the middle and posteromedial scallops in one; and the anterolateral, middle, and posteromedial scallops in one.These data suggest an association between coronary artery spasm and mitral valve prolapse. Coronary artery spasm may thus be an important factor in the pathogenesis of the chest pain, arrhythmias, electrocardiographic abnormalities, and sudden death, that have already been described in some patients with mitral valve prolapse. 相似文献
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Alex S. B. Yip Wing Hing Chow Denise F. M. Lee King Loong Cheung 《Clinical cardiology》1995,18(7):424-425
A 33-year-old man was investigated for dyspnea on exertion and the presence of a pansystolic murmur. Physical examination revealed dextrocardia confirmed by chest radiograph, which also showed oligemic right lung field. Subsequent cardiac catheterization revealed secundum atrial septal defect, persistent left sided superior vena cava, and severe mitral valve prolapse causing severe mitral regurgitation with pulmonary hypertension. The right pulmonary artery was absent. It is the first report of the association between severe mitral valve prolapse and absent right pulmonary artery. 相似文献
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A. Rückel R. Erbel B. Henkel G. Krämer J. Meyer 《International journal of cardiology》1984,6(5):633-637
We report a cerebral ischemia in a 23-year-old woman, in whom a mitral valve aneurysm with thrombotic masses was diagnosed by cross-sectional echocardiography. A prolapsing mitral leaflet was also visualized. 相似文献
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Eustaquio Onorato Pierluigi Festa Franois Bourlon Lecompte Yves Luigi Ballerini 《Catheterization and cardiovascular interventions》1996,37(2):162-165
A case of idiopathic right pulmonary artery aneurysm with pulmonary valve insufficiency simulating a mediastinal teratoma occurred in an asymptomatic 13-year-old boy. The key to correct diagnosis was pulmonary angiography. The patient was successfully treated with surgery. © 1996 Wiley-Liss, Inc. 相似文献
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Jay W. Mason Francis H. Koch Margaret E. Billingham Roger A. Winkle 《The American journal of cardiology》1978,42(4):557-562
Right ventricular endomyocardial biopsy was performed in 14 patients with mitral valve prolapse to determine the existence of an associated cardiomyopathic process. All 14 patients had echocardiographic, angiographic or auscultatory evidence of mitral valve prolapse, and all were symptomatic. The group had a high incidence rate of conduction system abnormalities (50 percent) and arrhythmias (64 percent), but only one patient had a significant hemodynamic abnormality. Light microscopy revealed an increase in endocardial and interstitial fibrosis in eight patients (57 percent). Electron microscopy, performed in 11 patients, showed mitochondrial degenerative changes in all 11. Nuclear chromatin clumping, intracell edema and myocyte degeneration were frequently present. It is concluded that endomyocardial and myocardial abnormalities exist in some symptomatic patients with idiopathic mitral valve prolapse. 相似文献