误诊为多种心外系统疾病的老年冠心病心力衰竭临床分析OACSTPCD

Objective To investigate the multi-system manifestations and early causes of misdiagnosis of heart failure caused by coronary heart disease(CHD)in the elderly.Methods The clinical data of 8 patients with heart failure caused by CHD misdiagnosed from January 2021 to June 2023 were analyzed.Results Among the 8 patients,2 patients had cough,phlegm,chest tightness and shortness of breath,wet rales at the bottom of both lungs,thickened and disordered lung texture,ST-T segment depression on electrocardiogram(ECG),history of chronic bronchitis,and were misdiagnosed as acute attack of chronic bronchitis.Of 3 patients,there was nausea,vomiting,and mild tenderness under xiphoid process in 2 patients,ab-dominal pain,diarrhea,mild tenderness around umbilicus in 1 patient,ST-T segment depression in 3 patients,and premature ventricular contractions in 2 patients,who had a history of chronic gastritis and were misdiagnosed with acute gastroenteritis.One patient was misdiagnosed as chronic hepatitis due to abdominal distension,loss of appetite,weakness,mild edema of both lower limbs and slight elevation of alanine aminotransferase.Two patients had dizziness,insomnia,irritability,sinus tachycar-dia on ECG,history of hypertension,history of hyperlipidemia,who were misdiagnosed with cerebral arteriosclerosis.After detailed inquiry about medical history and relevant treatment history and careful physical examination,relevant examinations were performed following consultation,heart failure due to coronary heart disease was confirmed.Misdiagnosis lasted 2 to 5 d.The prognosis was good after anti-heart failure treatment.The patients were followed up for six months and their condition was stable.Conclusion When elderly patients presented with symptoms of extracardiac system as the initial symptom,clinicians should inquire about the history of heart disease in detail,fully understand the accompanying symptoms,carefully perform physical examination,avoid missing relevant positive signs,and perform auxiliary examinations such as echocardiography and ECG in time,which can effectively avoid misdiagnosis.