Acute left heart failure,in a dangerous condition,proceeds rapidly,and timely and accurate diagnosis of it is the key to improve the prognosis of the patients.However,due to various reasons,there are still some patients cannot get timely and correct diagnosis.The article summarizes the diagnostic procedure of two patients with acute left heart failure.Both of them suffered from sudden difficulty in breathing,and were misdiagnosed as spontaneous pneumothorax and poor curative effect on AECOPD respectively.For patients with acute left heart failure who shows extreme difficulty in breathing,doctors should be familiar with their characteristic clinical manifestations,and cannot be affected by their superficial phenomenon.With the obviously accelerated heart rate,the possibility of patients developing left heart failure should be suspected.If there were difficulties in diagnosis,BNP level can contribute to the timely diagnosis of acute left heart failure,and thus avoid misdiagnosis and missed diagnosis.%急性左心衰竭病情凶险、进展迅速,及时、正确诊断是改善患者预后的关键.然而,仍有部分患者由于各种原因得不到及时正确的诊断与救治.本文总结两例急性左心衰竭患者的诊断过程,患者均突发呼吸困难,分别误诊为自发性气胸、慢性阻塞性肺疾病(COPD)急性加重期疗效不佳.对于急性左心衰竭表现为极度呼吸困难的患者,应熟悉其特征性临床表现,不能受患者表面现象影响,结合心率明显加快应怀疑左心衰竭可能,如诊断困难,检测B型脑钠肽水平有助于急性左心衰竭的及时诊断,从而避免误诊及漏诊.
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