临床误诊误治2026，Vol.39Issue(1)：1-6,6.DOI:10.3969/j.issn.1002-3429.2026.01.001
老年人射血分数保留心力衰竭临床误诊误治分析
Analysis of clinical misdiagnosis and mistreatment of heart failure with preserved ejection fraction in the elderly
摘要
Abstract
Objective To analyze the causes of clinical misdiagnosis and mistreatment of heart failure with preserved ejection fraction(HFpEF)in the elderly and the methods for correcting misdiagnosis,in order to improve the diagnosis and treatment level of clinicians.Methods A retrospective analysis was conducted on the clinical data of one patient misdiagnosed as pneumonia and one patient misdiagnosed as malignant pleural effusion and eventually diagnosed as HFpEF in the elderly from January 2021 to January 2023.The causes of misdiagnosis were summarized,and preventive measures were proposed.Results Two patients visited the hospital due to respiratory symptoms and pleural effusion respectively.Based on clinical symptoms and related examination findings,they were initially misdiagnosed as pneumonia and malignant pleural effusion respectively,and symptomatic treatment yielded unsatisfactory outcomes.After admission,further echocardiographic examinations revealed that all patients had structural or functional abnormalities of the heart.Laboratory tests indicated an increase in N-terminal pro-brain natriuretic peptide.Combined with clinical manifestations,they were diagnosed with HFpEF.The misdiagnosis lasted 7 d and 2 months respectively.After targeted treatment,the symptoms were alleviated significantly and cardiac function recovered.Conclusion The clinical symptoms of HFpEF in the elderly are atypical and prone to misdiagnosis.Enhancing clinicians' understanding and vigilance of this disease,conducting thorough physical examinations,completing relevant tests and closely observing the changes in the condition are the keys to reducing misdiagnosis of HFpEF in the elderly.关键词
射血分数保留心力衰竭/老年/误诊/肺炎/恶性胸腔积液/鉴别诊断/心功能/N末端脑钠肽前体Key words
heart failure with preserved ejection fraction/elderly/misdiagnosis/pneumonia/malignant pleural effusion/differential diagnosis/cardiac function/N-terminal pro-brain natriuretic peptide引用本文复制引用
陈慧波,王爱华,徐芳辉,李思明,朴海..老年人射血分数保留心力衰竭临床误诊误治分析[J].临床误诊误治,2026,39(1):1-6,6.基金项目
黑龙江省卫生健康委科研课题(2020-020) （2020-020）
