Morgan R, King D
Arrowe Park Hospital, Wirral, Merseyside, UK.
Postgrad Med J. 1995 Dec;71(842):738-40. doi: 10.1136/pgmj.71.842.738.
All patients with heart failure should have an echocardiogram to establish a diagnosis, both to aid treatment as well as for prognostic reasons. An audit of 100 case notes of patients admitted with acute left ventricular failure over a 12-month period found that 26 patients had not had an echocardiogram. Of the 74 who did have an echocardiogram 68 patients had reduced systolic function (mean ejection fraction 42%). Almost all (93%) were commenced on an angiotension-converting enzyme (ACE) inhibitor. Those who did not receive an ACE inhibitor had no contraindications to these drugs. Seventeen patients had a confirmed myocardial infarction. Of these, 11 had an echocardiogram and 10 were discharged home on an ACE inhibitor. Despite appropriate indications some patients are deprived of echocardiography as well as the benefits of ACE inhibitors.
所有心力衰竭患者都应进行超声心动图检查以明确诊断，这既有助于治疗，也出于预后考虑。一项对12个月内收治的100例急性左心室衰竭患者病历的审核发现，26例患者未进行超声心动图检查。在进行了超声心动图检查的74例患者中，68例患者收缩功能降低（平均射血分数42%）。几乎所有患者（93%）都开始使用血管紧张素转换酶（ACE）抑制剂。未接受ACE抑制剂治疗的患者并无使用这些药物的禁忌证。17例患者确诊为心肌梗死。其中，11例进行了超声心动图检查，10例出院时服用ACE抑制剂。尽管有适当的指征，但一些患者仍未接受超声心动图检查，也无法从ACE抑制剂中获益。
