老年人射血分数保留心力衰竭临床误诊误治分析OA

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.