How to treat refractory heart failure?

summary

The symptoms of heart failure can be rapidly improved by appropriate etiological treatment and conventional anti heart failure treatment (rest, salt restriction, diuretics, digitalis, ACEI, etc.). If the symptoms and signs of heart failure remain unchanged for a long time under conventional heart failure treatment or show progressive aggravation, it is called refractory heart failure. Let's share my experience with you.

How to treat refractory heart failure?

1. Diuretics should be individualized according to the degree of heart failure and the age, blood pressure and water electrolyte level of patients. It is still expected to improve the symptoms of heart failure by stopping, changing drugs, adjusting dosage and combining two diuretics.

2. Patients with refractory heart failure are more sensitive to the toxicity of digitalis, so it is not suitable to increase the dosage of digitalis to improve the curative effect of refractory heart failure. Studies have shown that the improvement of hemodynamics and autonomic nervous function is not higher than that of low-dose digoxin, but the incidence of adverse reactions and poisoning caused by the former is significantly increased.

3. The clinical manifestations of ACEI, renin activity, at Ⅱ and norepinephrine levels suggest that patients with heart failure who have sympathetic adrenergic nerve activity and hyperactivity of RAAS can use larger doses of ACEI or ACEI and norepinephrine β Receptor blockers were used in combination.

matters needing attention

Diet should be adjusted between solid, paste and liquid. Water or solid food is the most likely cause of dysphagia. Therefore, it is necessary to smash solid food before feeding it to the elderly. Water can not be directly to the elderly to drink, should be added to sugar free lotus root powder, almond cream and other viscous agents