对严重低钾血症误诊1例分析如下。1病历摘要女,71岁。因反复胸闷气短10a余,加重伴突发呼吸困难、端坐呼吸1d入当地医院门诊,以风湿性心脏病为诊断收住院。查体:BP 120/80mm Hg,P 90次/min,精神萎靡不振,口唇无发绀,颈静脉略显充盈,双肺呼吸音清,双肺底可闻及少许湿啰音,二尖瓣区可及3/6级收缩期隆隆样杂音,双下肢中度水肿,入院时查血钾3.4mmol/L,给予利尿(呋塞米)、强心、扩血管等治疗,而未予补钾。3d后患者出现乏力、厌食、明显腹胀、躁动等症状,且呼吸困难进一步加重,当地医院给予镇静治疗,并继续强心、利尿,未监测血电解质变化,患者上述症状逐 A case of misdiagnosis of severe hypokalemia is as follows. 1 medical record summary female, 71 years old. Due to repeated chest tightness and shortness of breath more than 10a, increased with sudden respiratory difficulties, sitting breathing 1d into the local hospital outpatient service, rheumatic heart disease diagnosis for hospitalization. Examination: BP 120 / 80mm Hg, P 90 beats / min, apathetic, lips cyanosis, slightly jugular filling, lung breath sounds clear, the bottom of the lung can be heard and a little wet rales, mitral valve area And grade 3/6 systolic rumbling noise, moderate lower extremity edema, admission check potassium 3.4mmol / L, giving diuretic (furosemide), cardiac, vasodilator and other treatment, without potassium. After 3d patients with fatigue, anorexia, abdominal distension, restlessness and other symptoms, and further increase in dyspnea, the local hospital for sedative treatment, and continue cardiac, diuretic, not monitored changes in blood electrolyte, the patient by the symptoms of