頁籤選單縮合
題 名 | 以發音過弱表現低心輸出量症候群的高齡長者--個案報告=A Case Report: Low-Cardiac-Output Syndrome Related to Hypophonia Caused by Sick Sinus Syndrome in an Elderly Patient |
---|---|
作 者 | 許喬琳; 梁志光; 周明岳; 林育德; | 書刊名 | 臺灣老年醫學暨老年學雜誌 |
卷 期 | 12:2 2017.05[民106.05] |
頁 次 | 頁141-150 |
分類號 | 417.7227 |
關鍵詞 | 病態竇房結症候群; 發音過弱; 低心輸出量症候群; 老年症候群; 多重用藥; Sick sinus syndrome; Hypophonia; Low-cardiac-output syndrome; Geriatric syndrome; Polypharmacy; |
語 文 | 中文(Chinese) |
中文摘要 | 一位85歲高齡男性,本身患有心衰竭、胸椎骨質疏鬆合併壓迫性骨折及早期失智症。病人每日均規則服用藥物,但入院前一個月開始有反覆跌倒現象,入院前五天更出現虛弱、食慾不振、發音過弱等症狀。病患過去有心臟衰竭的病史而長期使用多種調控心律的藥物,但這次住院病患並未出現喘、胸悶、雙下肢水腫等典型心衰竭症狀,反而表現反覆跌倒、說話聲音過小、虛弱、不願意吃東西等不典型症狀。住院後心電圖檢查高度懷疑病態竇房結症候群,經會診心臟科醫師後診斷為病態竇房結症候群合併低心輸出量症候群,經心律調節器置放後,病患症狀快速改善,願意吃飯,講話聲音也回復正常大小。提出此個案的主要目的是為了探討高齡病患的不典型疾病表現。當我們在診治老年患者時,不論是食慾不振、反覆跌倒或全身無力等老年症候群,一定要詳細評估病患跌倒的原因,面對類似症狀的病患時能將心衰竭列入鑑別診斷,尤其是心因性因素所導致全身無力。同時,改善多重藥物使用也是需要介入的一環。 |
英文摘要 | An 85-year-old man has histories of chronic heart failure, osteoporosis, T-spine compression fracture and mild cognitive impairment. In addition to antihypertensive medicine, diuretics, beta blocker and anti-platelet drug, he took hypnotics, lipid-lowering and anti-arrhythmia drug (Digoxin). He experienced recurrent falls during the one month prior to admission. He complained about progressively generalized malaise, anorexia and hypophonia around 5 days before admission. After admission, he was diagnosed with sick sinus syndrome and low-cardiac-output syndrome. He did not present with dyspnea, orthopnea, or legs edema. After pacemaker placement and suspension of all unnecessary medication, his symptoms ameliorated significantly, and there was no sign of hypophonia. This case of atypical presentation of low-cardiac-output syndrome as hypophonia reminds physicians of the importance of conducting differential diagnosis and drug screen in elderly patients for reducing polypharmacy-related adverse effects. |
本系統中英文摘要資訊取自各篇刊載內容。