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Related Concept Videos

Heart Failure I: Introduction01:27

Heart Failure I: Introduction

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Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
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Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
612
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

185
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

391
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
391
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

366
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
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Ageing, demographics, and heart failure.

Andrew J Stewart Coats1

  • 1Department of Medical Sciences, Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, Via di Val Cannuta 247, 00166 Roma, Italy.

European Heart Journal Supplements : Journal of the European Society of Cardiology
|December 31, 2019
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Summary

Heart failure (HF) disproportionately affects the elderly, with older patients often presenting with HFpEF and multiple comorbidities. Improved management and research focusing on patient-reported outcomes are crucial for this growing population.

Keywords:
ComorbiditiesElderlyEpidemiologyHeart failure

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Area of Science:

  • Cardiology
  • Geriatrics
  • Internal Medicine

Background:

  • Heart failure (HF) is a complex clinical syndrome with increasing prevalence, particularly among the elderly.
  • Older HF patients often have significant non-cardiac comorbidities, impacting treatment and outcomes.
  • Pathophysiological mechanisms and common etiologies of HF differ between younger (ischaemic heart disease, HFrEF) and older (hypertension, HFpEF) populations.

Purpose of the Study:

  • To highlight the unique challenges in managing heart failure in elderly patients.
  • To emphasize the need for research tailored to older adults with HF, especially those with HFpEF and comorbidities.
  • To advocate for a holistic approach in HF management, incorporating patient-reported outcomes and quality of life.

Main Methods:

  • This is a review and discussion of current understanding of heart failure in the elderly.
  • Analysis of differences in HF presentation and pathophysiology between younger and older patient cohorts.
  • Examination of treatment implications and outcomes in elderly HF patients with comorbidities.

Main Results:

  • Older adults with HF, particularly HFpEF, experience poorer outcomes compared to younger HFrEF cohorts.
  • Comorbidities in elderly HF patients complicate treatment, affecting response and tolerance.
  • Current research and clinical practice often do not adequately address the specific needs of older HF patients.

Conclusions:

  • Elderly patients with heart failure require a more individualized and holistic management strategy.
  • Future research must prioritize studies with older HF patients, including those with multiple comorbidities, and assess patient-reported outcomes.
  • Enhanced clinical trials and practice guidelines are needed to improve the care and outcomes for the aging HF population.