心脏病学案例30例 pdf snb 115盘 kindle 在线 下载 pmlz mobi

　　《心脏病学案例30例（原版影印）》的病例都是按照美国医师*考试的形式严格编写，对每一个病例有问题、答案和详细的分析。并有延伸的问题。问题设计精巧，分析透彻，尤其体现了学科之间的交叉。适合学生扩展阅读，拓展临床思维，尤其适合PBL（问题为中心的学习）和CBL（案例为中心的学习）。

Contributors

Acknowledgraenls

Introduction

Section Ⅰ

How to Approach the Cardiology Patient

Part 1. Cardiovascular History and Physical Examination

Part 2. Approach to the Electrocardiogram (ECG)

Part 3. Cardiovascular Providers and Procedures

Section Ⅱ

Clinical Cases

Thirty Case Scenarios

Cases 1-5. Coronary and Vascular Diseases

Cases 6-10. Structural Heart Diseases

Cases 11-15. Rhythm Disorders

Cases 16-20. Pump Disorders

Cases 21-25. Consults and Complaints

Cases 26-30. Other Cardiac Diseases

Section Ⅲ

Listing of Cases

Listing by Case Number

Listing by Disorder (Alphabetical)

Index

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《心脏病学案例30例（原版影印）》：

　　In cases where sepsis is suspected， blood and urine cultures are obtained prior to the use of broad-spectrum antimicrobial agents to cover infective etiologies. Laboratory data to exclude other causes of distributive shock such as pancreatitis， adrenal failure， toxin ingestions， and thyroid disease should also be obtained.

　　Management of Hypovo emic Shock Hypovolemic shock is managed in a fashion similar to distributive shock， namely， goal-directed vo ume resuscitation （or transfusion in the setting of known or suspected bleeding） and judicious vasopressor support. Addressing the underlying cause for the hypovolemia is also key.See also Case I （acute coronary syndrome/STEMI） and Case 2 （acute coronary syndrome/NSTEMI）.

　　3.1 A 75-year-old man with a history of hypertension， diabetes， and complete heart block that was treated with a permanent pacemaker several years ago arrives at the ICU from the orthopedic surgery service for shock management. He is one day removed from an elective right total hip replacement， and his surgery was reportedly uncomplicated. His preoperative dobutamine echocardiogram revealed normal ventricular function and no evidence of ischemia. On arrival he is pale and somnolent but arousable. Vital signs: blood pressure （BP）80/40 mmHg， heart rate （HR） 50 bpm， respiratory rate （RR） 18/min， temperature 37.9℃， and oxygen saturation 96% on romn air. On examination his neck veins are flat at 45~. His cardiopulmonary examination is normal. His extremities are cool and without edema. Laboratory rate includes the following:BUN 50， creatinine 1.8 mg/dL， hemoglobin 6.0 g/dL， mean corpuscular volume （MCV） 89， and white blood ceils （WBC） 12，000 with normal differential.Cardiac biomarkers are normal. ECG reveals a paced ventricular rhythm. Two units of blood are ordered， and 2 L of normal saline is infused rapidly. After fluid resuscitation his examination is unchanged and his blood pressure is now 84/45 mmHg.

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