Key result
Heart failure mimics acute cholecystitis in two young men presenting with upper abdominal pain.
Why the study?
Early diagnosis of heart failure can be challenging due to diverse clinical manifestations, occasionally leading to misdiagnosis.
Case Report (n=2)
No
Heart failure can present atypically with acute upper abdominal pain and be misdiagnosed as acute cholecystitis, emphasizing the importance of comprehensive evaluation including BNP and echocardiography.
BACKGROUND: Heart failure is a clinical syndrome characterized by decreased cardiac output, leading to systemic organ hypoxia and resulting in dyspnea, pulmonary edema, organ congestion, and pleural effusion. Owing to the diverse clinical manifestations of heart failure, early diagnosis can be challenging, and misdiagnosis may occur occasionally. The use of echocardiography and blood brain natriuretic peptide can aid in obtaining a more accurate diagnosis. CASE PRESENTATION: This article presents two case reports of patients who were misdiagnosed with acute cholecystitis. Both patients were young Mongolia males (age 26 and 39 years) who presented to the emergency department with acute upper abdominal pain, abdominal ultrasound revealed gallbladder enlargement, and blood tests suggested mild elevation of bilirubin levels. However, despite the absence of procalcitonin and C-reactive protein elevation, the patients were admitted to the general surgical department with a diagnosis of "acute cholecystitis." Both patients were given treatment for cholecystitis, but their vital signs did not improve, while later examinations confirmed heart failure. After treatment with diuretics and cardiac glycosides, both patients' symptoms were relieved. CONCLUSION: We aim to highlight the clinical manifestations of heart failure and differentiate it from rare conditions such as acute cholecystitis. Physicians should make accurate diagnoses on the basis of physical examinations, laboratory testing and imaging, and surveys while avoiding diagnostic heuristics or mindsets. By sharing these two case reports, we hope to increase awareness to prevent potential complications and improve patient outcomes.
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Yu et al. (2024) conducted a case report in Heart failure misdiagnosed as acute cholecystitis (n=2). Anti-heart failure therapy (diuretics and cardiac glycosides) was evaluated. Two young male patients presenting with acute upper abdominal pain were initially misdiagnosed with acute cholecystitis but were later correctly diagnosed with heart failure and successfully treated.
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