典型心力衰竭根据临床症状、体征及有关检查不难做出诊断。当缺乏典型体征或合并其它疾病时,往往容易造成误诊或漏诊。现将我们遇到的不典型心力衰竭举例报告分析如下,以期从中吸取教训,提高对不典型心力衰竭的早期诊断水平。一、胃肠炎型例1:某女,41岁。上腹不适,恶心、呕吐,轻度浮肿2天。查体:无发绀,门诊坐位听诊心肺未发现异常体征,腹部平软,上腹部压痛,下肢无浮肿,初步诊断为急性胃肠炎,给予对症治疗。3天后,患者出现上腹胀,恶心,呕吐加重,卧位检查可闻及二尖瓣区舒张期隆隆样杂音,肝于右肋下可触及3cm,压痛明显,透视下见左心房与右心室均扩大。给予利尿剂后,恶心、呕吐消失,肝脏缩 Typical heart failure based on clinical symptoms, signs and related tests is not difficult to make a diagnosis. When the lack of typical signs or other diseases, often easy to cause misdiagnosis or missed diagnosis. Now we encounter the typical cases of atypical heart failure report is analyzed as follows, in order to learn from them to improve the early diagnosis of atypical heart failure. First, gastroenteritis Example 1: a woman, 41 years old. Abdominal discomfort, nausea, vomiting, mild swelling for 2 days. Physical examination: no cyanosis, outpatient sitting auscultation heart and lungs found no abnormal signs of abdominal soft, upper abdominal tenderness, lower extremity no edema, the initial diagnosis of acute gastroenteritis, given symptomatic treatment. Three days later, the patient experienced abdominal distension, nausea and vomiting. The lying position examination could detect diastolic rumbling noise in the mitral valve area. The liver was accessible to the right rib for 3 cm. The tenderness was conspicuous. Under the fluoroscopy, both the left atrium and the right ventricle were seen expand. After giving diuretics, nausea, vomiting disappeared, the liver shrinks