老年退行性心瓣膜病38例误诊分析

目的：分析老年性退行性心瓣膜病的误诊原因，以减少临床误诊率。方法：采用回顾性方法分析38例误诊为其它心脏疾病的老年退行性心瓣膜病患者的临床资料。结果：误诊为冠心病23例（60．5％），扩张型心肌病6例（15．8％）．风湿性心脏病6例（15．8％），甲亢性心脏病3例（7．9％）；38例病人均表现为不同程度的胸闷、心悸、活动后气促；常规胸片检查：17例发现主动脉钙化，未发现心内钙化影，所有患者心脏超声检查均有瓣膜钙化．其中23例存在瓣膜功能不全。结论：本病的症状、体征缺乏特异性，常规X线摄片检出率并不高．故易误诊。对原因不明的心律失常、心功能不全老年患者应注意超声心动图等检查，综合判断，早日确诊。

Analysis of misdiagnosis in aged patients with retrogression valvular disease

Objective： To analysis the misdiagnosis rate of aged patients with retrogression valvular disease. Methods： Clinical data from 38 cases of aged patients with retrogression valvular disease those were misdiagnosed as other cardiac disease were analyzed retrospectively. Results： In these cases, 23 cases were misdiagnosed as coronary heart disease （60.5%）, 6 cases as dilated cardiomyopathy （15.8%）, 6 cases as rheumatic heart disease （15.8%）, and 3 cases as hyperthyroid heart disease （7.9 %） . All of these patients had some symptoms of chest distress, palpitation, and/or paining. Calcification of aorta was only detected in 17 cases with a conventional chest radiograph. Inversely, valvular calcification could be found in all of patients by ultrasoundcardiogram, of which 23 cases had valvular dysfunction. Conclusion： Aged retrogression valvular disease is easily misdiagnosed as other cardiac disease due to lack of specific symptoms or physical signs and low detection rate of conventional chest radiograph. So, it should be screened by ultrasoundcardiogram etc. in patients with eryptogenetic arrhythmia, heart failure, and heart murmur.