Clinical Analysis of Cardiac Diseases Misdiagnosed as Acute Liver Failure

GUO Sheng; LIU Changhong; LIU Ying; LIAO Yan; WEI Yingfeng

doi:10.3969/j.issn.1002-3429.2024.04.003

Abstract：Objective To investigate the clinical characteristics and causes of misdiagnosis of heart disease as acute liver failure,and to summarize preventive measures.Methods The clinical data of 3 patients with heart disease who were in-itially misdiagnosed as acute liver failure from April 2021 to August 2022 were retrospectively analyzed.Results One patient presented with fatigue,chest tightness,palpitation and abnormal liver function,one patient presented with chest tightness which was aggravated with loss of appetite,fatigue,and one patient presented with shortness of breath and chest tightness with no obvious triggers,accompanied by cough,sputum,fatigue,loss of appetite,edema of both lower limbs.After the relevant biochemical examination,the initial diagnosis was misdiagnosis as acute liver failure.Afterwards,1 patient was diagnosed with valvular heart disease with atrial fibrillation and acute cardiac insufficiency by color Doppler echocardiography,and 2 pa-tients were diagnosed with malignant pericardial effusion and pericardial tamponade secondary to pulmonary malignancy by col-or Doppler echocardiography and pericardiocentesis.All 3 patients were given further treatment after symptoms were relieved.Conclusion The possibility of heart disease should be considered when patients present with symptoms similar to liver fail-ure,such as fatigue,chest tightness,abnormal liver function,and coagulation dysfunction.Clinicians should be proficient in the diagnosis and differential diagnosis of heart disease and liver failure,inquire about the medical history in detail,pay atten-tion to physical examination,and perform the relevant examination as soon as possible,so as to improve the diagnostic accura-cy,and reduce or avoid misdiagnosis and treatment.