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孙某某,男,64岁。思高血压(?)13年,冠心病6年。因活动后心悸,气短1个月入院,体检:(?)p16/12Kpa,(双侧胧动肿血压一致):口唇发(?),肝颈静脉回流征阳性,双肺底对称性细湿罗音,心(?)向左下扩大,心率98次/分,律整,S_1减弱,心尖部可闻及2/5(?)(?)风样,SM向左腋下传寻,主动脉瓣二区可闻及舒张叹气样杂音,向心尖部传导。肝大,双下肢浮肿。心电图:冠脉供血不足。X线:主动脉影明显增宽,左心扩大。B超:心包积液,主动脉根部扩张。核磁共振:主动脉((?)主动脉—腹主动脉一双肾中郭水平)夹层动脉瘤形成,监床诊断,主动脉夹层动脉瘤(Ⅰ型)、冠心病、心功能Ⅲ级、高血压病Ⅲ期。经应用β受体阻滞剂与钙离子拮抗剂及扩血管药物治疗24天,心功能代偿出院。随访3年,病人坚持服药,病情稳定。
Sun Moumou, male, 64 years old. Thought high blood pressure (?) 13 years, 6 years of coronary heart disease. After the event of palpitations, shortness of breath 1 month admitted to hospital, physical examination: (?) P16 / 12Kpa, (both bilateral arterial swelling and blood pressure): lips (?), Positive hepatic jugular vein reflux, Luo Yin, the heart (?) To the left under the expansion of the heart rate 98 beats / min, law, S_1 weakened, apex can be heard and 2/5 (?) Valves can be heard in the second district and diastolic sigh noise, to the apical conduction. Large liver, both lower extremities edema. ECG: coronary insufficiency. X-ray: aortic shadow was significantly wider, left ventricular enlargement. B super: pericardial effusion, aortic root expansion. Nuclear magnetic resonance: aorta ((?) Aorta - abdominal kidney in a pair of kidney Guo level) dissection aneurysm formation, supervisory diagnosis, aortic dissection aneurysm (type Ⅰ), coronary heart disease, cardiac function grade Ⅲ, hypertension Disease Ⅲ. The application of β-blockers and calcium antagonists and vasodilator drugs for 24 days, compensated discharge of cardiac function. Follow-up 3 years, the patient insisted on medication, stable condition.