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老年人慢性心力衰竭:仍然是一个当前的医学问题。

Chronic heart failure in the elderly: still a current medical problem.

作者信息

Skrzypek Agnieszka, Mostowik Magdalena, Szeliga Marta, Wilczyńska-Golonka Magdalena, Dębicka-Dąbrowska Dorota, Nessler Jadwiga

机构信息

Department of Medical Education, Jagiellonian University Medical College, Kraków, Poland.

John Paul II Hospital, Kraków, Poland.

出版信息

Folia Med Cracov. 2018;58(4):47-56.

Abstract

Congestive heart failure (CHF) is the final stage in several heart diseases. The diagnosis of CHF in older patients is a challenge. Preserved left ventricular systolic function is a characteristic type of CHF in seniors. The purpose of the study was to characterize elderly patients with CHF and to highlight specific features of the conditions in seniors. e most common etiology of HF in this group of patients is hypertension and coronary heart disease. In seniors atypical presentations of chronic heart failure is much more common than in younger patients. Malnutrition, limitations of exercise and sedentary lifestyles or comorbid diseases have an influence on asymptomatic, early stage of HF. There are better outcomes of treatment in obese individuals. It is called the obesity paradox. Open communication with a patient and his/her family may improve their response to therapy. When heart failure becomes an incurable disease and aggressive treatment is ineffective, palliative care should be considered in end-of-life heart failure patients. The goal of treatment in the remaining moments of life last moments of life should be maximizing the patient's comfort.

摘要

充血性心力衰竭(CHF)是多种心脏病的终末期阶段。老年患者CHF的诊断具有挑战性。左心室收缩功能保留是老年人心力衰竭的一种特征类型。本研究的目的是描述老年CHF患者的特征,并突出老年人病情的特定特征。该组患者中最常见的心力衰竭病因是高血压和冠心病。在老年人中,慢性心力衰竭的非典型表现比年轻患者更为常见。营养不良、运动受限和久坐的生活方式或合并症会影响心力衰竭的无症状早期阶段。肥胖个体的治疗效果更好。这被称为肥胖悖论。与患者及其家人进行开放沟通可能会改善他们对治疗的反应。当心力衰竭成为不治之症且积极治疗无效时,对于终末期心力衰竭患者应考虑姑息治疗。在生命的最后时刻,治疗的目标应该是最大限度地提高患者的舒适度。

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