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患者男性6岁,生后发现心脏杂音,逐渐加重。活动量小,无晕厥史。常患呼吸道感染。体检:发育中等,面容紫绀,有杵状指,血压正常。ECC示窦性心律,心房扩大,右心室肥厚。临床拟诊:先天性心脏病,复杂畸形。影像学检查: X线平片上心脏呈靴型,并明显增大,主要为右心室增大。心胸比率0.61。肺纹理不少,外围变细,中下野略呈网状。两上纵隔阴影增宽,凸向锁骨上区,左侧更明显。气管下段右缘有压迹,提示为右位主动脉弓。考虑为重症法乐氏四联症,需与
6-year-old male patients, after birth, heart murmur, gradually increased. Small amount of activity, no history of syncope. Often respiratory tract infection. Physical examination: medium development, face cyanosis, clubbing means, normal blood pressure. ECC shows sinus rhythm, atrial enlargement, right ventricular hypertrophy. Clinical diagnosis: congenital heart disease, complex deformity. Imaging examination: X-ray plain heart-shaped boots, and significantly increased, mainly for the right ventricle increased. Mythical ratio 0.61. A lot of lung texture, peripheral thinning, a little reticular network. Mediastinal shadow on both widened, convex to the supraclavicular region, the more obvious left. Tracheal lower right edge of the pressure trace, suggesting that the right aortic arch. Considered as Severe Tetralogy of Fallot, need to be with