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主治医师:请实习医生报告病历。实习医师:患者,女,57岁,主因发作性心悸、胸闷10年,加重3天于1991年7月16日入院,现已住院16天。1981年以来反复发作性心悸、胸闷,多因劳累、情绪激动诱发,发作持续2小时至3天,发作时心电图示:心房纤颤,心室率最快达180次/分,分别口服奎尼丁、心律平、静注西地兰可转复为窦性心律,发作间歇1周至3月不等。今年2月因发作性心前区疼痛在我院诊断为急性高侧壁心肌梗塞,住院治疗1个月后好转出院。今年4月复查T_3,T_4偏高,口服他巴唑10mg3次/d治疗,半月后出现乏力、纳差而停用他巴唑并口服甲状腺片20mg1次/d,一周后症状缓解停药。近3月来心悸、胸闷发作频繁,心律平,西地兰转复效果不佳,门诊以快速房颤收治。既往有
Attending physician: ask the intern to report the medical record. Intern: Patient, female, 57 years old, mainly due to episodes of palpitations, chest tightness 10 years, aggravating 3 days admitted on July 16, 1991, is now hospitalized for 16 days. Repeated onset of palpitations since 1981, chest tightness, due to exertion, emotionally induced seizures continued for 2 hours to 3 days, the onset of ECG: atrial fibrillation, ventricular rate as fast as 180 beats / min, respectively, oral quinidine , Heart rate, intravenous cedilanol can be converted to sinus rhythm, seizures intermittent 1 week to March range. February of this year because of episodes of pre-cardiac pain in our hospital diagnosed with acute high-grade myocardial infarction, hospitalization 1 month after the discharge improved. Review of T_3 in April this year, T_4 high, oral methimazole 10mg3 times / d treatment, half a month after the emergence of fatigue, anatomy and stop taking methimazole and oral thyroid tablets 20mg1 times / d, a week later to relieve symptoms. Palpitations in the past three months, frequent chest tightness, heart rhythm flat, cedilanid poor recovery, outpatient admitted to atrial fibrillation. Past there