临床荟萃 ›› 2024, Vol. 39 ›› Issue (5): 440-444.doi: 10.3969/j.issn.1004-583X.2024.05.009

• 论著 • 上一篇    下一篇

以谵妄为首发症状的老年心力衰竭病例3例并文献复习

王婷a(), 柴春艳a, 李敏b   

  1. 陕西省人民医院 a.老年病院西院一病区;b.保健办,陕西 西安 710068
  • 收稿日期:2023-11-22 出版日期:2024-05-20 发布日期:2024-07-05
  • 通讯作者: 王婷,Email: tinasees@163.com
  • 基金资助:
    陕西省重点研发计划——基于干部保健十年健康管理模式的团体单位健康管理服务适宜技术研(2021SF-352);陕西省重点研发计划——老年HFpEF患者25(OH)D水平及其与心功能、生活质量的关系(2022SF-059)

Three cases review and literature review of elderly heart failure patients with delirium as the initial symptom

Wang Tinga(), Chai Chunyana, Li Minb   

  1. a. First Impatient Area of West Court; b. Health Office, Shaanxi Provincial People's Hospital, Xi'an 710068, China
  • Received:2023-11-22 Online:2024-05-20 Published:2024-07-05
  • Contact: Wang Ting, Email: tinasees@163.com

摘要:

目的 分析以谵妄为首发症状的老年心力衰竭病例临床特点、误诊原因、治疗方法。方法 回顾性分析以谵妄为首发症状的老年心力衰竭病例3例。结果 该3例患者均无典型气短、气喘等心力衰竭典型表现,均以谵妄为首发症状,2例诊断考虑老年痴呆,1例诊断考虑脑器质性精神障碍,其中2例曾就诊于神经内科,治疗效果不佳,于我科就诊后结合心脏超声、N末端B型利钠肽前体结果诊断心力衰竭,改善心功能治疗后谵妄状态好转。结论 当老年患者出现精神行为异常,应考虑谵妄可能,应拓展思路,综合评估,尤其既往有心脏疾患时,应排查有无心功能异常。

关键词: 谵妄, 心力衰竭, 老年

Abstract:

Objective To analyze the clinical characteristics, misdiagnosis reason and treatment methods in elderly heart failure (HF) patients with delirium as the initial symptom. Methods Three elderly HF patients with delirium as the initial symptom were retrospectively analyzed. Results None of the three patients had typical symptoms of heart failure such as shortness of breath and asthma, and all of them took delusion as the initial symptom. Two cases were diagnosed with senile dementia and one case with brain organic mental disorder. Among the three patients, two cases had been treated in the department of neurology, but the treatment effect was not satisfactory. HF was diagnosed by results of echocardiography and N-terminal pro-brain natriuretic peptide in our department, and delirium was improved after improving cardiac function. Conclusion When elderly patients experience mental and behavioral abnormalities, the possibility of delirium should be considered. Thinking should be broadened and comprehensive assessment should be carried out. Especially if there is a previous heart disease, abnormal cardiac function should be checked.

Key words: delirium, heart failure, aged

中图分类号: