患者，女，65岁。查体：心尖搏动出现在心音增强。应首先考虑的是

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SQL Error: select id,body,options from ***_enewstiku where sourceid='28441' and id < 2323003 and id<>'2323003' order by id desc limit 5 SQL Error: select id,body,options from ***_enewstiku where sourceid='28441' and id > 2323003 and id<>'2323003' order by id asc limit 5