心源性双侧大量胸腔积液一例误诊（One case of cardiac bilateral massive pleural effusion misdiagnosed）.docVIP

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心源性双侧大量胸腔积液一例误诊（One case of cardiac bilateral massive pleural effusion misdiagnosed）.doc

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心源性双侧大量胸腔积液一例误诊（One case of cardiac bilateral massive pleural effusion misdiagnosed）

心源性双侧大量胸腔积液一例误诊（One case of cardiac bilateral massive pleural effusion misdiagnosed） One case of cardiac bilateral massive pleural effusion misdiagnosed Update Date: 09-13 Wang Zhongli Keywords valvular heart disease / diagnosis; pleural effusion / diagnosis; Misdiagnosis; aortic valve insufficiency / diagnosis; aortic valve prolapse / diagnosis; tuberculosis; pleura / diagnosis; Key, words, Heart, valve, diseases/diagnosis, Pleural, effusion/diagnosis, Diagnostic, errors, Aortic, valve, insufficiency/diagnosis, Aortic, valve, prolapse/diagnosis, Tuberculosis,, pleural/diagnosis 1 case data Male, 51. Intermittent chills, fever 10 Yu Tian, chest distress for 1 weeks, the local hospital X-ray and CT examination showed bilateral pleural effusion, diffuse pulmonary edema, diagnosis of tuberculous pleurisy with isoniazid, rifampicin and ethambutol triple antituberculosis therapy, oral prednisone 40 mg/d, bilateral pleural effusion is still stubborn growth. Transferred to our hospital in January 6, 1998. Physical examination: body temperature is 36 degrees, pulse is 84/min, respiration is 20/min, blood pressure is 18.5/10 kPa. No lip cyanosis, jugular venous engorgement, middle trachea, thoracic slightly plump, weakened lungs language fibrillation, eighth rib percussion dullness, decreased breath sounds. The heart rate 84/min, located in the apex line left clavicle, apex palpable diastolic aortic tremor; the first and the second were audible and grade III diastolic murmur halitus, sitting forward more obvious, and transfer to the neck and xiphoid; apex can be heard and double phase II murmur. Palpable blood stream, femoral artery, gunshot, and capillary pulsation were positive. The abdomen soft, under the liver right rib 1.5 cm, the quality is soft, does not have the tenderness, the spleen has not touched, both lower limbs do not have dropsy. Laboratory examination: blood, urine, stool routine and liver function and electrolytes were not abnormal. Urea nitrogen 8.9 mmol/L