英文病例分析-心肌梗死.ppt

英文病例分析-心肌梗死.ppt

《英文病例分析-心肌梗死.ppt》由会员分享，可在线阅读，更多相关《英文病例分析-心肌梗死.ppt（22页珍藏版）》请在冰点文库上搜索。

Caseanalysis,病例分析,ChiefComplaints,Paroxysmalprecordiumpainfor2months，exacerbationfor16hours.,病例分析,Medicalhistory：

achelocation、character、degree？

radiation？

duration？

Inducingandrelieffactor？

treatmentprocess?

病例分析,Presentillness,Paroxysmalprecordiumpaininthepast2months.Brokeoutafteragitationoroverworked,lastfor2-3minutes，relievedafterrest,didnttreatment.,病例分析,Presentillness,Precordiumpainaggravatedwithoutinducingfactor16hoursago,accompaniedwithbackandbothupperlimbspain,leftshoulderandupperlimbobviously,accompaniedwithnausea.Takenomeprazolecapsule,thesymptomcouldntrelieve,precordiumpainstillexistedpersistentlyafterlocalhospitaltreatment.,病例分析,Presentillness,Inemergencyroomofourhospital,taken“aspirin300mg,ticagrelor180mg”,“isosorbidemononitrate20mg”intravenousdrip.,病例分析,PastMedicalHistory：

2014.09.19gastroscope:

esophagitis,gastriculcer,erosivegastritis,duodenalbulbinflammation.FamilyHistory：

Hismotherhavehistoryofhypertension,coronaryheartdiseaseanddiabetes.Brotherhashistoryofdiabetesandhypertension.,病例分析,Physicalexamination：

Vitalsigns!

Chestandheartexaminationabdomenexamination,病例分析,T36.7,P72/min,R20/min,BP117/75mmHg.Regularrespirations.Noedemaineye-lips.Thelipsarered.Nosternumtenderness.Breathingsoundsarerough,withbothbottomofthelungmoistrales.Noabnormalpulsationanupliftinprecordialregion.Theheartpercussednormalinsize.Heartbeat72.Abdomenisflat,Notenderness.Nodistension.,病例分析,Diagnosis,Differentialdiagnosis,病例分析,病例分析,Differentialdiagnosis？

AnginaAcutepericarditisAcutepulmonaryembolismAcuteabdominalpainAorticdissection,病例分析,Auxiliaryexaminations？

病例分析,ECG：

Themostimportantthemostquickly,Location,InferiorwallaVFAnteriorwallV16AnteroseptalwallV1-3ApicalorlateralwallV46Posteriorwall-V7-9Right-sided-V4R-V5R,15,病例分析,cTnI7.092ng/mL,CK-MB156.43ng/mL，MYO251.09ng/ml。

X-ray:

heartshadowincreased,bronchitis.UCG：

Segmentalventricularwallmotionabnormalities,EF：

45%.,病例分析,Diagnosis1.coronaryheartdiseaseacuteanteriorwallmyocardialinfarctionKillipclassII.2.bronchialpneumonia.3.esophagitis,gastriculcer,erosivegastritis,duodenalbulbinflammation.,病例分析,Complications？

DysfunctionorruptureofpapillarymuscleRuptureoftheheartEmbolismCardiacaneurysmPostinfarctionsyndrome,病例分析,Treatment,General：

Stayinbedmonitoring,oxygenPainreliefanti-ischemiaAnti-plateletanti-coagulationReperfusionthrombolytictreatmentPCICABG,病例分析,HowselectthrombolytictreatmentorPCI?

361224,病例分析,preventionAABBCCDDEE,ThankYou!