病例报告患者,女,48岁,已婚,农民。心悸、胸闷27年,症状加重伴双下肢浮肿半月。患者27年前,因胸闷、心悸去当地医院就医,发现心率缓慢,平时约40～50次/分。近6～7年来,每遇劳累时口唇青紫。半月前无明显诱因,又胸闷心悸,心前区不适,并逐渐出现双下肢浮肿,尿少、纳呆、恶心、不咳、无夜间阵发性呼吸困难。曾服利尿剂,浮肿消退,但仍感胸闷心悸,而来院就诊。病程中无头昏、黑蒙、发作性晕厥等。于1985年9月28日入院。既往无咽痛或关节酸痛史,无反复咳嗽、咳痰史。自幼智力良好。体力比同年龄人差,尚能从事轻度农业劳动。体检:体温37.5℃,脉搏44,呼吸20,血压112/72。发育良好,消瘦,神清,自动体位,呼吸平稳,唇 Case report Patient, female, 48 years old, married, farmer. Heart palpitations, chest tightness, 27 years, exacerbations with swelling of the lower extremities half a month. Patients 27 years ago, due to chest tightness, palpitations go to the local hospital for medical treatment and found that the heart rate is slow, usually about 40 to 50 beats / min. Nearly 6 to 7 years, every case of bruising lips lips. Half a month ago no obvious incentive, chest tightness and heart palpitations, precordial discomfort, and gradually lower extremity edema, oliguria, poor appetite, nausea, no cough, no paroxysmal nocturnal dyspnea. Had served diuretics, edema subsided, but still feel chest tightness palpitations, and came to hospital. No dizziness in the course of the disease, dark, episodic fainting and so on. In September 28, 1985 admission. No past history of sore throat or joint pain, no repeated cough, sputum history. Since childhood, good intelligence. Poor physical ability than the same age, still able to engage in light agricultural work. Physical examination: body temperature 37.5 ℃, pulse 44, breathing 20, blood pressure 112/72. Well-developed, weight loss, clear, automatic position, breathing steady, lips