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患者女,82岁。胸闷、胸痛4天至当地医院诊治,心电图提示三度房室传导阻滞,予临时起搏器植入治疗。因症状未缓解转至浙江省人民医院,行急诊床旁心脏超声检查发现起搏电极导线穿透心尖部室间隔进入左室心尖部,并穿透心尖部肌层进入心包腔,合并心包积液。经多科室联合会诊,急诊行全麻下心脏损伤修补术+起搏导线安置术。
Female patient, 82 years old. Chest tightness, chest pain for 4 days to the local hospital for treatment, electrocardiogram prompted third degree atrioventricular block, to the temporary pacemaker implantation. Due to the symptoms did not ease to go to Zhejiang Provincial People’s Hospital, emergency bedside cardiac ultrasound examination found that the pacemaker leads penetrate the apical ventricular septal into the left ventricular apex, and penetrate the apical muscular layer into the pericardial cavity, combined pericardial effusion. The multi-department federation consultation, emergency line under general anesthesia repair cardiac pacing + cable placement.