摘 要：本院门诊收治1例阵发性室上性心动过速、房颤、胸痛患者。门诊查心电图示阵发性室上性心动过速。住院第2天患者诉胸背部剧烈疼痛，血压下降、心律不齐，音强弱不等，心电图示心房颤动、ST-T改变，心肌酶升高。考虑急性冠脉综合征，转上级医院行冠脉造影示：冠脉造影正常；心包积液。行心包引流后病情好转。通过该病例提示心包积液和急性心肌梗死的鉴别诊断很重要。特别病情复杂时，尽早行胸部X线和超声检查有助于鉴别诊断。

    关键词：室上性心动过速；房颤；胸痛；心包积液

    中图分类号：R547.71 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.12.063

    文章编号：1006-1959(2018)12-0190-02

    Abstract：In this hospital，1 patient with paroxysmal supraventricular tachycardia，atrial fibrillation，and chest pain was treated. Outpatient electrocardiogram shows paroxysmal supraventricular tachycardia.On the second day of hospitalization，the patient complained of severe chest pain，decreased blood pressure，irregular heartbeat，and weak sound intensity.ECG showed atrial fibrillation ......