不知道算不算是查了资料的循环TBL病例资料..doc

血液循环TBL案例 学习目标： 1.掌握心肌细胞特性、动作电位及其形成机制 2.掌握心肌兴奋—收缩耦联机制与心脏的泵血机制 3.理解心脏泵血功能的评价 4.理解影响心输出量的因素 5.理解心血管系统的神经调节及体液调节 6.熟悉心电图波形的形成机制及意义 7.熟悉血管的分类，各自的生理特征及血流动力学相关内容 8.了解心衰的定义和发病机制 9.了解相关心脏疾病如冠心病，心肌梗塞的病因、发病机制、临床表现、诊断和治疗原则等 10.培养综合政治、经济、文化等各方面因素制定心力衰竭诊治策略的思路。 Case Description： Huang, 66 years-old female, came to the clinic complaining about dyspnea and chest pain for 5 years and worsening for 1 month. The patient was diagnosed as “hypertension” six years ago and the BP level could reach to 180/110mmHg, complicated with paroxysmal dizziness, chest pain and palpitation, could relieve spontanously, thus no treatment is conducted. 5 years ago for the first time the patient present a suddent, colic, obtuse, press pain on the low part of the sternum and radiate to the left shoulder, last for about half minute, remited after rest. She consulted the local hospital and was diagnosed as “angina pectoris” and was treated with nitroglycerin(dosage unknown), response effectively. Since then the patient start to take “β-blocker” on a regular base for the hypertension, the patient herself considered the BP level controlled well, but didn’t monitor the BP on a regular base. Daily activity is limited, dyspnea, chest pain sometimes presented after housework or 30 minutes walk, could be relieved after rest. The synptom kept worsening and half year ago the patient presented a typical paroxysmal nocturnal dyspnea, relieved after taking sitting position. One month ago, without obvious inducing factor, the patient present suddent, severe, post-sternum supression pain, last for more than 10 minutes and couldn’t relieved after taking nitroglycerin. Diagnosed as “coronary heart disease” at the local hospital, sent to our hospital two days ago for further treatment. The patient is forced to take sitting position, mild dyspnea at rest and worsen after activity and agitation. The patient is conscious, cooprate for the physical examination, normal unrination and defecation, normal appetite. 病例描述： 主诉：反复胸闷，胸