患儿男，10岁，发热伴咳嗽1天，2小时 前突然感胸闷不适、腹痛、烦躁不安，晕厥一次。体检：体温38.5℃，面色苍白，气稍促，血压60/40mmHg。心率50次/min，心律不 齐，心音强弱不一，心界扩大。首选的实验室检査是

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