Old Misdiagnosis of heart failure.docVIP

 PAGE \* MERGEFORMAT 5 Old Misdiagnosis of heart failure [Abstract] heart failure is a complex clinical syndrome is due to various reasons, the initial myocardial injury caused by changes in cardiac structure and function, leading to lower ventricular pump function. Its main features are shortness of breath, fatigue, exercise tolerance decreased, and fluid retention caused by pulmonary congestion and peripheral edema. elderly patients with cardiac dysfunction is a common illness, symptoms typical of the diagnosis is not difficult, but the symptoms are not typical or early heart failure, due to disease specific symptoms more complex, prone to misdiagnosis. [Keywords:] Misdiagnosis of heart failure aged A typical case Example 1. Female, 68 years old, mainly due to cough, sputum, chest tightness, anti-infection treatment for 5 days, the symptoms do not ease, difficulty in breathing, particularly at night for the re-admission. Examination: the end of smell and wet lung rales, heart rate 130 beats / min, ECG showed ST-T changes. The cardiac, diuretic, expanding treatment for 3 days after the crown, cough, sputum disappeared. diagnosis of coronary heart disease, left heart failure. Example 2. Male, 70 years old, because of dizziness, apathy, irritability, confusion hospital. Previous history of hypertension. Examination: BP: 170/110mmHg, head CT was normal. The number of patients occurred at night, irritability, wheezing , lungs and wet rales heard at the end. electrocardiogram showed STV1-V5 down 0.1-0.15mv. chest X-ray said: dual markings improved. to the expansion of the crown, the symptoms disappeared after diuretic treatment. Example 3. Female, 58 years old, because of abdominal distension, right upper quadrant pain with nausea and vomiting, hospitalization. Rehydration by anti-inflammatory treatment of acute cholecystitis to be invalid, then palpitations, shortness of breath, supine limited. Repeated questioning history, past det