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乙胺碘呋酮是一种抗心律失常范围较广,疗效高,毒性小的药物。近年来随着临床应用的日趋普遍,副作用的报道也相应增多。我们曾遇到1例服用乙胺碘呋酮死亡者,提示该药偶尔可致严重心律失常,应引起重视。 患者男性,32岁,农民。1972年在部队体检时,曾发现“心脏有杂音”,当时未加重视,亦无不适,能正常参加部队一切活动。1974年复员回乡后,亦能胜任繁重体力劳动。1980年开始相继出现心悸、气促、浮肿等症状,至1982年11月病情加重,不能平卧,且出现夜间阵发性呼吸困难,乃于1982年12月13日入院。体查:体温38℃。心率130次/分,心律绝对不规则,心前区可扪得舒张期震颤,听诊心尖区可闻Ⅱ级收缩期吹风性杂音及舒张期中度隆隆性杂音,可闻开瓣音,主动脉瓣区闻及Ⅱ级收缩期吹风性杂音,副区听到舒张期吹风性杂音。入院诊断为:风湿性心脏病,联合瓣膜病;二尖瓣狭窄;主动脉瓣闭锁不全;心房纤颤;心力衰竭Ⅱ级。
Amiodarone is a broad antiarrhythmic drug with high potency and low toxicity. In recent years, with the increasing popularity of clinical applications, reports of side effects also increased accordingly. We have encountered 1 case of death of amiodarone, suggesting that the drug occasionally cause serious arrhythmia, should pay attention. Male patient, 32 years old, farmer. In 1972 when the military physical examination, they found “heart murmur”, at that time no emphasis, no discomfort, can participate in all normal military activities. After demobilizing people to go back to their homeland in 1974, they are also capable of handling heavy manual labor. Since 1980, palpitations, shortness of breath, edema and other symptoms have appeared one after another. Until November 1982, the patient became worse and unable to supine. He developed paroxysmal nocturnal dyspnea and was hospitalized on December 13, 1982. Physical examination: body temperature 38 ℃. Heart rate 130 beats / min, the heart rate is absolutely irregular, precordial palpable diastolic tremor, auscultatory apex area can be heard Ⅱ systolic murmur and moderate diastolic murmur noise, can be heard open tone, aortic valve District hearing and grade Ⅱ systolic hair blowing noise, deputy heard diastolic hair blowing noise. Admission diagnosed as: rheumatic heart disease, valvular disease; mitral stenosis; aortic valve atresia; atrial fibrillation; heart failure Ⅱ.