老年人心力衰竭的诊断与管理
Diagnosis and Management of Heart Failure in Older Adults.
作者信息
Panjrath Gurusher, Ahmed Ali
机构信息
Department of Medicine, George Washington University, 2150 Pennsylvania Avenue, NW, Suite 8-416, Washington, DC 20037, USA; Inova Heart and Vascular Institute, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA.
Department of Medicine, George Washington University, 2150 Pennsylvania Avenue, NW, Suite 8-416, Washington, DC 20037, USA; Center for Health and Aging, Veterans Affairs Medical Center, 50 Irving Street NW, Washington, DC 20422, USA; Department of Medicine, University of Alabama at Birmingham, 933 19th Street South, CH19 201, Birmingham, AL 35294, USA.
出版信息
Heart Fail Clin. 2017 Jul;13(3):427-444. doi: 10.1016/j.hfc.2017.02.002.
Aging is characterized by heterogeneity, both in health and illness. Older adults with heart failure often have preserved ejection fraction and atypical and delayed clinical manifestations. After diagnosis of heart failure is established, a cause should be sought. The patient's comorbidities may provide clues. An elevated jugular venous pressure is the most reliable clinical sign of fluid volume overload and should be carefully evaluated. Left ventricular ejection fraction must be determined to assess prognosis and guide therapy. These 5 steps, namely, diagnosis, etiologic factor, fluid volume, ejection fraction, and therapy for heart failure may be memorized by mnemonic: DEFEAT-HF.
衰老的特征是在健康和疾病方面都存在异质性。患有心力衰竭的老年人通常射血分数保留，临床表现不典型且延迟。心力衰竭诊断确立后，应寻找病因。患者的合并症可能提供线索。颈静脉压升高是液体容量超负荷最可靠的临床体征，应仔细评估。必须测定左心室射血分数以评估预后并指导治疗。这五个步骤，即心力衰竭的诊断、病因、液体容量、射血分数和治疗，可以通过记忆口诀“DEFEAT-HF”来记住。
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