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患者男性,17岁。于跑步后出现上腹痛伴恶心,呕吐,同时觉心前区沉重压迫感,经休息后稍有缓解,晚饭后不久上腹又出现剧烈疼痛伴冷汗,持续约2h后缓解,翌日晨5时上腹再次出现剧痛,伴恶心,呕吐,出冷汗而急诊,以急性胃炎入院。体检:T36.7℃,P96/min BP15.4/9.8Pa,心律齐,第一心音稍低钝,心尖区听到1级收缩潮杂音,上腹轻度压痛,无肌紧张及反跳痛,肝、脾未触及。入院后给予阿托品肌肉注射,输液,在输液过程中病人出现胸闷、心慌,不能平卧,听诊心律不齐,可听到过早搏动,随即作心电图示ST~Ⅱ、Ⅲ、avF V_(5-6)呈弓背型抬高 0.2—0.4mv,并可见病理性Q波。按急性心梗治疗后病情稳定,一月后复查心电图ST_Ⅱ、Ⅲ、avF、V~(5-6)导联遗
Patient male, 17 years old. After running with abdominal pain associated with nausea and vomiting, and feel critical pressure in front of the area, a slight relief after a rest, shortly after dinner and abdominal pain appeared with severe cold sweat continued lasted about 2h after the remission at 5:00 the next morning Severe abdominal pain again, with nausea, vomiting, cold sweat and emergency, admitted to acute gastritis. Physical examination: T36.7 ℃, P96 / min BP15.4 / 9.8Pa, heart rate Qi, the first heart sound is slightly lower blunt, heard a twitch apex tidal noise, mild abdominal tenderness, no muscle tension and rebound Pain, liver, spleen not touched. Atropine was administered intramuscularly and infused intravenously after admission. The patient developed chest tightness and palpitation in the course of infusion, and was unable to lie down. Hearing irregular heartbeat and premature beating could be heard. Then electrocardiogram ST ~ Ⅱ, Ⅲ, avF V_ (5- 6) was arch dorsal raise 0.2-0.4mv, and visible pathological Q waves. According to the treatment of acute myocardial infarction after a stable condition, January review electrocardiogram ST_ Ⅱ, Ⅲ, avF, V ~ (5-6)