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患者男,73岁。因咳嗽、咳痰10天,以“支气管炎”入院。5年前曾患“急性前壁心肌梗死”。体检:R24次/min,BP20/12kPa(150/90mmHg)。双肺可闻及散在的干性啰音,心界向左下扩大,心率70次/min,律齐,心音稍钝,未闻及杂音,腹部无殊。住院期间心电图(附图上行)示:V_1、V_2导联呈rS型,V_3呈QS型,V_4呈Qrs型,V_5、V_6有起始q波。次日患者胸痛、胸闷、烦躁,BP10/8kPa(79/60mmHg),心率64次/min,偶闻期前收缩。临床诊断:再发心肌梗死。出现症状3h后心电图(中行)可见Ⅰ、Ⅱ、Ⅲ、aVF、V_4—V_6导联ST段明显下移,T波倒置,STv_3较前次下降,STv_1、avR抬高,V_2导联r波稍增高,V_3由QS变为rS型,V_4Q波亦消失,出现r波,V_5、V_6q波消失,V_(3R)—V_(5R)均呈QS
Male patient, 73 years old. Due to cough, sputum for 10 days to “bronchitis” admitted. 5 years ago had “acute anterior myocardial infarction.” Physical examination: R24 times / min, BP20 / 12kPa (150 / 90mmHg). The lungs can be heard and scattered in the dry rales, the heart bound to the left to expand the heart rate 70 times / min, law Qi, heart sound blunt, no smell and noise, abdomen without special. ECG during hospitalization (the upper line in the figure) shows: V_1, V_2 lead was rS type, V_3 was QS type, V_4 was Qrs type, V_5, V_6 have initial q wave. The next day patients with chest pain, chest tightness, irritability, BP10 / 8kPa (79 / 60mmHg), heart rate 64 beats / min, even before the onset of contraction. Clinical diagnosis: recurrent myocardial infarction. 3h after onset of symptoms, the ST segment of Ⅰ, Ⅱ, Ⅲ, aVF and V_4-V_6 leads showed a significant downward shift, T wave inversion, STv_3 decreased compared with the previous one, STv_1 and avR increased, V_2 lead r slightly V_3 and V_6q disappeared, while V_3 and V_6q disappeared. V_3R-V_5R appeared QS