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心力衰竭（心衰）患者脑卒中、肺栓塞和周围动脉栓塞事件比一般人群高，但窦性心律心衰患者的抗凝治疗存在争议。本文报告一例窦性心律扩张型心肌病心衰患者，住院期间出现急性大面积脑梗塞的治疗及抢救过程，结合文献介绍窦性心律心衰患者抗凝治疗策略，以期在临床工作中更为规范管理心衰患者的抗凝治疗，避免住院期间严重栓塞事件的发生。“,”The incidence of stroke, pulmonary embolism and peripheral arterial embolism in patients with heart failure (HF) is higher than that in the general population. However, anticoagulant therapy is controversial in HF patients with sinus rhythm (SR).This paper reported the treatment and rescue process of a HF patient with dilated cardiomyopathy and SR complicating acute massive cerebral infarction during hospitalization, and introduce the principles of anticoagulant therapy in HF patients with SR based on literature review, in order to standardize the management of anticoagulant therapy in HF patients with SR and avoid serious embolism during hospitalization.