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女性,24岁,主因反复晕厥10年,频繁发作3月入院。患者近10年来每当体育活动时突发心慌,继而晕厥,2~3min苏醒后乏力明显,无肢体活动及言语障碍。3月来,晕厥8次,多于体力活动、快步行走中出现。动态心电图示频发房性早搏,阵发房颤,间歇性房室干扰脱节,交界性逸搏心律,最慢心率40bpm,最快心率160bpm,拟行永久性起搏器治疗。否认器质性心脏病史。入院查体:未见阳性体征。入院心电图:窦性心律,频发房性早搏,短阵房速。超声心动图示:左房内径31mm,左室舒张末径53mm,右房内径34mm,右室舒张末径27mm,左室射血分数0.43,左室壁运动普遍减弱,左室收缩功能下
Female, 24 years old, mainly due to repeated syncope for 10 years, frequent episodes of hospitalization in March. Patients in the past 10 years whenever physical activity when the sudden panic, then fainting, 2 ~ 3min awake after the obvious fatigue, no physical activity and speech impairment. March, syncope 8 times, more than physical activity, walking in the walk. Dynamic ECG showed frequent atrial premature beats, paroxysmal atrial fibrillation, intermittent atrioventricular out of line, junctional escape rhythm, the slowest heart rate 40bpm, the fastest heart rate 160bpm, to be the permanent pacemaker treatment. Denied the history of organic heart disease. Admission examination: no positive signs. Admission ECG: sinus rhythm, frequent atrial premature beats, a short burst of atrial tachycardia. Echocardiography: left atrial diameter 31mm, left ventricular diastolic diameter 53mm, right atrial diameter 34mm, right ventricular end diastolic diameter 27mm, left ventricular ejection fraction 0.43, left ventricular wall motion generally weakened, left ventricular systolic function