严重冠心病可以导致进行性心脏扩大和充血性心力衰竭,有时很难与非缺血性心肌病鉴别。本文一例缺血性心肌病病人生前一度误诊为原发性扩张型心肌病,现报告如下,并对缺血性心肌病的病理生理和诊断作简要复习。患者女性,56岁,市民。自1980年11月开始感劳累后心慌、气短,有时胸闷,但无心前区疼痛,查心电图为\\\"完全性左束支传导阻滞\\\"。1981年10月以后反复发作夜间阵发性呼吸困难,长期服用\\\"洋地黄\\\"、\\\"利尿剂\\\"。两个月米休息状态亦感呼吸困难,不能平卧,伴恶心、食欲不振、咳嗽、 Severe coronary heart disease can lead to progressive heart enlargement and congestive heart failure, and sometimes difficult to identify with non-ischemic cardiomyopathy. This article a case of ischemic cardiomyopathy patients misdiagnosed as primary dilated cardiomyopathy in the lifetime, are reported as follows, and a brief review of the pathophysiology and diagnosis of ischemic cardiomyopathy. Patient female, 56 years old, citizen. Since November 1980 began to feel tired tired, shortness of breath, and sometimes chest tightness, but no pain in precordial area, check ECG is \"complete left bundle branch block.\" Occur in October 1981 after repeated episodes of paroxysmal nocturnal dyspnea, long-term use \\ \"digitalis \\\", \\ \"diuretics \\\". Two-month-old rice rest state also feel breathing difficulties, not supine, with nausea, loss of appetite, cough,