A 64 year okd man with pakpitation and short breat
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(The 13th case)
Department of cardiology, Shenyang General Hospital of PLA, 110016 Shenyang, China
Case Presentation
A male patient, 64 years old, received esophageal carcinoma radical surgery in Nov 1989. In March 1991, the symptom of cough took place because of cold. He was admitted into the hospital for palpitation and short breath after taking erythromycin. He denied the history of hypertension, diabetes mellitus and coronary heart disease. Physical examination on admission: BP 110/78 mmHg, P 40 bpm, R 16 bpm. ECG results: Ⅲ°AVB; ventricular escape rhythm; complete right bundle branch block; ST segment depression ≥0.05 mV in leads Ⅱ, Ⅲ, aVF and V49; ST segment elevation >0.1 mV in lead V13; T wave elevation in leads Ⅰ,Ⅱ and aVL and T wave drop in lead aVF. XRay chest radiography result: pneumonia of right lung. UCG result: no heart image was showed at left edge of sternum but beartmage could be seen in the area near the xiphoid process. Diagnosis on admission: Ⅲ°AVB ; infection in lung. He did not respond to antiinfective and symptomatic treatments, and died of circulatory and respiratory failure 15 days later. Autopsy findings: a gigantic metastatic squamous cell carcinoma on interventricular septum, with metastasis to mediastinal lymph nodes; carcinomatous cell emboli in left and right pulmonary arteries accompanied with hemorrhagic infarct in inferior lobe of right lung ; lobular pneumonia.
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