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男患,28岁.因劳累后心悸、气短半年来诊.查体:口唇无紫绀,心率92次/分,律齐,胸骨左缘3、4肋间可听到Ⅳ级收缩期粗糙杂音,P_2>A_2.心电图P波高大.使用HP1000型彩色多普勒超声诊断仪.探头频率2.5MHz.显示右房、右室内径增大.三尖瓣隔叶与二尖瓣前叶在室间隔附着点之间的室间隔呈缝隙样回声中断,并见该处室间隔向右房内膨出呈0.6cm×0.7cm之囊袋状.收缩期增大,舒张期缩小.彩色多普勒显示收缩期左室内血流通过室间隔中断处进入囊袋,射向右心房,与三尖瓣迫流束交汇呈“十字”型,脉冲多普勒取样容积置于囊袋右房侧可取到收缩期湍流频谱.超声诊断:
Male patient, 28 years old. Palpitations and shortness of breath after exhausting for half a year. Physical examination: No cyanosis in lips, heart rate 92 beats/min, regular systolic murmurs in the intercostal space between the 3rd and 4th intercostal spaces on the left sternal border. P_2>A_2. Electrocardiogram P wave is tall. Use HP1000 type color Doppler ultrasound diagnostic instrument. The probe frequency is 2.5MHz. It shows that the right atrium and right ventricular diameter increase. The tricuspid valve and the anterior mitral valve are attached at the interventricular septum. The interventricular septum between the points was interrupted by a slit-like echo, and the septum of the ventricular septum showed a pouch shape of 0.6cm×0.7cm in the interventricular septum. The systolic phase increased and the diastolic phase shrank. Color Doppler showed contraction. Left intraventricular blood flow enters the capsular bag through the interventricular septum and is directed at the right atrium. The confluence with the tricuspid valve forced flow beam is a “cross” type. The pulsed Doppler sampling volume is placed on the right atrial side of the capsular bag and can be taken to the systolic phase. Turbulence spectrum. Ultrasound diagnosis: