Schmaltz A A
Universitätsklinikum Essen, Klinik und Poliklinik für Kinder- und Jugendmedizin.
Klin Padiatr. 1999 Jan-Feb;211(1):1-10. doi: 10.1055/s-2008-1043754.
Congestive heart failure is the inability of the heart to provide a sufficient output at a sufficient arterial pressure for the metabolic needs of the organism. Having presented the physiologic mechanisms of the contraction of the heart and its regulatory mechanisms the different aspects of classification of heart failure and its neurohormonal modulation are described. The epidemiology of heart failure in childhood is largely unknown, the causes vary considerably, symptoms are age-dependent. Main diagnostic tools for etiologic clarification are echocardiography and chest-x-ray. Focus of therapy is to eliminate the causes, but general recommendations may not be forgotten. Medical treatment of acute severe heart failure is use of catecholamines, ino- and vasodilators in the intensive care unit. Therapy of chronic heart failure is performed with diuretics, digitalis and ACE-inhibitors. Their pharmacologic effect, therapeutic trials in adults and children and peculiarities of pharmacology and side effects in childhood are reported. Low dose beta-blockers are a new therapeutic strategy still not established in children.
充血性心力衰竭是指心脏无法在足够的动脉压下提供足够的心输出量以满足机体的代谢需求。在介绍了心脏收缩的生理机制及其调节机制后，描述了心力衰竭分类的不同方面及其神经激素调节。儿童心力衰竭的流行病学情况很大程度上尚不清楚，病因差异很大，症状因年龄而异。用于病因明确的主要诊断工具是超声心动图和胸部X光片。治疗的重点是消除病因，但一般建议也不能被忽视。急性重症心力衰竭的药物治疗是在重症监护病房使用儿茶酚胺、正性肌力药和血管扩张剂。慢性心力衰竭的治疗使用利尿剂、洋地黄和血管紧张素转换酶抑制剂。报告了它们的药理作用、在成人和儿童中的治疗试验以及儿童药理学特点和副作用。低剂量β受体阻滞剂是一种新的治疗策略，在儿童中尚未确立。
