Valacio R, Lye M
Department of Geriatric Medicine, University of Liverpool.
Br J Clin Pract. 1995 Jul-Aug;49(4):200-4.
Both prevalence and incidence of heart failure rise with age. Diagnosis of heart failure in the older patient may be difficult because of atypical symptoms or the acceptance of symptoms as manifestations of old age. Heart failure is not a diagnosis but a syndrome. Echocardiograms should be obtained in most elderly patients to aid diagnosis and assessment. Loop diuretics, taking into account the altered homoeostasis of old age and presence of co-morbidity, are the mainstay of symptomatic treatment. ACE inhibitors are likely to benefit survival, although formal trials have failed to include many older patients. Digoxin and direct vasodilators are less well tolerated in elderly patients.
心力衰竭的患病率和发病率均随年龄增长而升高。老年患者心力衰竭的诊断可能存在困难，这是由于症状不典型或患者将症状视为衰老的表现。心力衰竭并非一种诊断，而是一种综合征。大多数老年患者均应进行超声心动图检查，以辅助诊断和评估。考虑到老年患者体内内环境稳定的改变及合并症的存在，袢利尿剂是症状性治疗的主要药物。血管紧张素转换酶（ACE）抑制剂可能对提高生存率有益，尽管正式试验未纳入很多老年患者。老年患者对地高辛和直接血管扩张剂的耐受性较差。
