扩张性心肌病的临床表现往往缺乏特异性,临床诊断仍需依赖“排它诊断”法。其中最难鉴别的是冠心病。本文报告一例老年扩张性心肌病出现手风琴效应(Accordion effect),并结合文献,对心肌病和冠心病的鉴别诊断,以及手风琴效应产生机理和临床意义加以探讨。 Dilated cardiomyopathy clinical manifestations often lack specificity, clinical diagnosis still need to rely on “exclusive diagnosis” method. One of the most difficult to identify is coronary heart disease. This article reports on an Accordion effect in elderly patients with dilated cardiomyopathy and explores the mechanisms and clinical implications of the literature for the differential diagnosis of cardiomyopathy and coronary heart disease, as well as the accordion effect.