King D
Department of Medicine, Arrowe Park Hospital, Wirral, Merseyside, UK.
Postgrad Med J. 1996 Oct;72(852):577-80. doi: 10.1136/pgmj.72.852.577.
Heart failure is common in the elderly and is associated with a significant morbidity and mortality. It accounts for about 5% of adult medical admissions and the expenditure of 1% of the total National Health Service budget. Clinical presentation in old age may be with the classical symptoms of heart failure but often, due to multiple pathology and low functional ability, presentation is atypical. Both nonspecific symptoms and signs of heart failure, are often a delayed presentation in this population, make diagnosis difficult. Treatment of the failing heart in an older person is similar to the young however, diligence is required when prescribing due to age-related pharmacokinetic changes and co-existent morbidity. This may result in polypharmacy and an increase in drug interactions which themselves may have deleterious consequences. However, knowledge of the aetiology of heart failure in old age and the possible atypical presentation as well as available treatments, will result in better management and improved quality of life and reduced mortality in the elderly heart failure population.
心力衰竭在老年人中很常见，与较高的发病率和死亡率相关。它约占成人内科住院病例的5%，占国民医疗服务体系总预算的1%。老年患者的临床表现可能是典型的心力衰竭症状，但由于存在多种病理状况和功能能力低下，表现往往不典型。心力衰竭的非特异性症状和体征在这一人群中常常出现较晚，使得诊断困难。老年人心力衰竭的治疗与年轻人相似，然而，由于年龄相关的药代动力学变化和并存的疾病，在开药时需要格外谨慎。这可能导致用药过多和药物相互作用增加，而这些相互作用本身可能会产生有害后果。然而，了解老年人心力衰竭的病因、可能的非典型表现以及可用的治疗方法，将有助于更好地管理患者，提高老年心力衰竭患者的生活质量并降低死亡率。
