哑型风湿性心瓣膜病较少见,但因其临床表现无特异性,缺乏杂音,易引起误诊。笔者遇到2例,均误诊为冠心病,现报告如下。例1:男,56岁。因反复胸闷、气促9年,再发10天于1989年1月13日入院。曾多次就诊于当地卫生院,胸片检查示左房左室增大,诊断为冠心病并心力衰竭。查体:体温36.8℃,脉搏100次/分,呼吸24次/分,血压18.5/12.0kPa。神清,半卧位,口周轻度紫绀。心界向左下扩大,律不齐,偶发早搏,杂音未闻及。肺部无罗音。心电图:窦速,偶发房早,左室高电压。胸片:左房左室增大;肿部呈淤血改变。超声心动图:二尖瓣增厚,回声增强,瓣口狭窄呈鱼嘴样改变,舒张期开放受限;主 Dumb rheumatic heart valve disease is rare, but because of its non-specific clinical manifestations, the lack of noise, easily lead to misdiagnosis. I encountered two cases were misdiagnosed as coronary heart disease, are as follows. Example 1: Male, 56 years old. Due to repeated chest tightness, shortness of breath 9 years, 10 days recurrence was January 13, 1989 admission. Has repeatedly visited the local hospitals, chest X-ray examination showed increased left ventricular mass, diagnosis of coronary heart disease and heart failure. Physical examination: body temperature 36.8 ℃, pulse 100 beats / min, breathing 24 beats / min, blood pressure 18.5 / 12.0kPa. God clear, semi-recumbent position, mouth mild cyanosis. Heart to the left to expand, irregular, premature coincidence, murmur not heard. Lung no Luo sound. Electrocardiogram: sinus speed, sporadic room early, left ventricular high voltage. Chest X-ray: Left atrium left ventricular enlargement; swelling was congestion changes. Echocardiography: mitral valve thickening, enhanced echogenic, petal stenosis was fish-mouth-like changes, diastolic opening restricted; the main