Fluid retention is a clinical manifestation in patients with multiple organ failure and acute myocardial infarction. What are the diseases that need to be identified when fluid retention occurs? First, rheumatic fever and rheumatic carditis is the primary cause of heart failure in school-age children, often in winter and spring. Heart failure is most common in children with severe carditis, and left heart failure or total heart failure is common in the acute stage. The main manifestations are: 1. 2-3 weeks before the onset of acute tonsillitis or pharyngitis often have a history of attacks; 2. fever and anemia and other systemic symptoms; 3. palpitations, shortness of breath, precordial discomfort, tachycardia (disproportionate to the body temperature X cardiac enlargement, systolic murmur, diastolic gallop rhythm, precordial tingling and pericardial friction sounds and other signs of pericarditis; 4. acute arthritis, joint pain, annular erythema, erythema nodosum. Erythema nodosum. Extracardiac manifestations such as subcutaneous nodules; 5. Prolongation of the P-5 interval on electrocardiogram; 6. Increased erythrocyte sedimentation rate, elevated titer of anti-streptavidin (positive reactive protein, increased bulge protein is of auxiliary diagnostic significance. Viral myocarditis often causes heart failure in infants, and rheumatic carditis is difficult to distinguish, such as murmurs suggestive of valvular involvement, then support the diagnosis of rheumatic carditis. Rheumatic heart valve disease is the most common cause of heart failure in young people and adults, and can also be seen in school-age children. Heart failure is often triggered by upper respiratory tract infection, rheumatic activity, exertion, atrial fibrillation, pregnancy, childbirth, or anemia. Early heart failure is often characterized by pulmonary hemorrhage or left heart failure, and in severe cases, pulmonary edema may occur. The late stage is usually chronic total heart failure. Rheumatic valvular disease is characterized by mitral stenosis, mitral bipathy (stenosis combined with insufficiency of closure), or bicuspid valvular disease [stenosis and/or insufficiency of the mitral and aortic valves]. The diagnosis of heart valve damage can be made on the basis of murmur characteristics, among other things. However, in heart failure, the diastolic murmur of mitral valve stenosis or aortic valve insufficiency can be covered by the breath sounds of pulmonary stasis or the completed sounds of the lungs, leading to atrial fibrillation or accelerated ventricular rate affecting ventricular myocardial filling, which can also make the murmur reduced or disappeared, making the diagnosis difficult until the murmur is easy to hear after the heart failure is controlled. Dilated cardiomyopathy and anemic heart disease can also be due to the formation of mitral valve enlargement of the relative closure of the mitral valve insufficiency, can appear in the apical region of the 2/6-3/6 level systolic murmur or diastolic murmur, and organic mitral valve closure insufficiency is distinguished from the control of heart failure or anemia is reduced or disappeared. Echocardiography has unique value in diagnosing the presence of organic mitral stenosis and aortic stenosis. Third, hypertensive heart disease heart failure is mostly seen in patients with essential hypertension, renal hypertension and pregnancy toxemia, and early manifestation of left heart failure. There are palpitation, shortness of breath and telangiectasia after exertion. In severe cases, cardiogenic asthma occurs at night, with breathing with rales, accompanied by cough and extreme dyspnea. It may also progress rapidly to acute pulmonary edema or a sudden drop in blood pressure and shock. Cardiogenic asthma must be differentiated from bronchial asthma by: 1) Cardiogenic asthma has a cardiac basis that causes acute pulmonary stasis, such as hypertension, myocardial infarction. Mitral stenosis, and bronchial asthma cases have a history of allergies, the past has a long history of asthma; ② the former more than middle-aged, often in the sleep attack, sitting or standing up to alleviate, while the latter is more common in young people, any time can be attacked, winter and spring more attacks; ③ the former has hypertension, mitral stenosis or aortic valve lesions signs, left ventricular and left atrial enlargement, often have a Prancing Horse Rhythm, the lungs wet ambiguous sound and dry very sound (rumbling), while the latter has normal or temporarily slightly elevated blood pressure, normal heart, and rumbling in the lungs; 4) X-ray examination, the former has an enlarged heart and pulmonary stasis, while the latter has a normal heart and clear lung fields. Primary hypertension complicating heart failure is most common in middle-aged patients or older, slightly more in men, often with a 5-10 year history of hypertension, with blood circuits over 21/13 kPa (160/100 mmHgg), physical examination, X-rays and electrocardiograms show obvious left ventricular hypertrophy and strain and other changes, and echocardiograms show an increase in the left intraventricular diameter, a widening of the aorta, a stiffer aortic wall and an increase in the thickness of the interventricular septum and the left ventricular wall. Increased thickness of the septum and left ventricular wall. Caused by pregnancy toxicity. Dynamic failure is the sudden onset of heart failure in late pregnancy, during labor or delivery, or within 10 d postpartum or longer. Various degrees of hypertension are usually present. Proteinuria and edema are the basic signs of gestosis. The onset of acute, to the left heart failure force main, often in bed rest or sleep suddenly attack. x-ray examination of the heart shadow enlargement, electrocardiogram has ST-T changes, and primary hypertension and chronic nephritis heart failure, and the identification of the disease is no past history, and in the postpartum heart failure control after six months of heart morphology can be restored to normal. Fourth, renal heart disease Acute glomerulonephritis cardiovascular changes are: ① hypertension; ② heart enlargement; ③ electrocardiogram shows myocardial damage; ④ heart failure. Acute glomerulonephritis patients with heart failure, 15% -30% more than occurred in the first week of the disease, manifested as acute left heart failure or total heart failure. In severe cases, acute pulmonary edema develops, which can be life-threatening within a few hours to 1-2d. The development of heart failure is associated with hypertension,, myocardial damage and sodium and water retention, increased blood volume, especially the latter is more important. The disease is more common in children, more boys than girls, and is preceded by a history of streptococcal infection. Edema (downward edema starting from the face first), oliguria, hematuria, increased blood pressure to diastolic blood pressure increase significantly. A few may be complicated by hypertensive encephalopathy or convulsions. The heart is mildly or moderately enlarged and may be in gallop rhythm. Electrocardiogram shows myocardial damage or left ventricular hypertension. Laboratory tests have the urinary changes of acute glomerulonephritis. Diagnosis is generally not difficult.