患者男，72岁，因“活动后胸闷、心悸、气促2年，加重2 d”来诊。患者活动后胸闷、心悸、气促2年，近2 d上呼吸道感染后症状加重，轻微活动易出现阵发性呼吸困难。陈旧性广泛前壁心肌梗死，病史8年。查体：P 110次/min，BP 160/90 mmHg；端坐呼吸，皮肤干、冷；双肺散在哮鸣音，双侧肺底可闻及细湿性啰音，P2亢进，心脏各瓣膜区未闻及杂音；腹平软，肝、脾肋下未触及；双下肢无水肿。血清肌钙蛋白正常。ECG：窦性心律，频发房性期前收缩，V
～V
导联ST段压低0.05～0.10 mV。
该患者目前最可能的诊断是（）
A.气道梗阻
B.肺动脉栓塞
C.支气管哮喘
D.急性心肌梗死
E.急性左侧心力衰竭
参考答案：E
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| Ever since I was little, my favorite season was winter. I loved to play in the snow and enjoy the hot chocolate. 1 , winter never gave me the special gift of snow on my birthday. I would ask my grandmother 2 it didn't snow on my birthday. She would laugh and tell me I asked too many questions. 3 one day, she promised (许诺) that she would make it snow on my next birthday. That year, 4 my birthday, my grandmother died. I was sad but angry because she had promised to make it snow. The day of my sixth birthday, I woke up and ran to the window, 5 to see just one snowflake. But there was no snow. I felt mad at my grandmother. She had broken a promise. By my sixteenth birthday, I 6 all hope of getting my snow, even though I still wished for 7 . During my party, I stayed with my friends and family and was truly happy. I 8 the best time ever! Then I saw the white snow 9 down all around. I was so excited that I ran around screaming (尖叫) and laughing. My friends all laughed 10 me, but I didn't care. When I 11 home, my grandpa said he had a gift for me. I was 12 because he had given me a gift. It was a small white box, which looked old. I opened it. There was a crystal snowflake (水晶雪花) with a card that 13 , "Happy Birthday." How could this be? My grandpa said it was my grandmother's final 14 on my "sweet sixteenth". I cried. I was 15 that my smiling grandmother angel was and had been watching over me. | ||||
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