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Hjertesvikt, kronisk

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Definisjon:
Klinisk symptomkompleks som en følge av at hjertets minuttvolum er for lavt til å dekke kroppens behov. Oftest en komplikasjon til koronar hjertesykdom eller hypertensjon.
Forekomst:
Forekomst øker med alder. Prevalens over 10 % ved alder > 75 år
Symptomer:
Hovedsymptomene er tung pust ved anstrengelse og økt trettbarhet. Økende plager ved økende grad av svikt.
Funn:
Ved u.s.: Lateralt forskjøvet apex, halsvenestuvning, deklive ødemer, gallopprytme. Ev. takypne, blek, slapp.
Diagnostikk:
Blodprøver med tanke på utløsende årsaker. NT-proBNP forhøyet. EKG patologisk. Ekkokardiografi er diagnostisk.
Behandling:
Behandles med livsstilstiltak, legemidler og ofte korreksjon av utløsende årsak. ACE-hemmere og betablokker er standard til alle med redusert ejeksjonsfraksjon i venstre ventrikkel (< 40%). Ellers er medikamentvalg avhengig av effekt av standardbehandling, årsak til og grad av hjertesvikt.
  • Nasjonal behandlingstjeneste for organtransplantasjon, Oslo universitetssykehus HF, nettsted 
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  • Bjørnar Grenne, PhD, konst. overlege, Klinikk for hjertemedisin, St. Olavs Hospital, Trondheim
  • Ingard Løge, spesialist i allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Jørund Straand, spesialist i allmennmedisin og førsteamanuensis dr. med., Seksjon for allmennmedisin, Universitetet i Oslo
  • Stein Samstad, spesialist i kardiologi, overlege Medisinsk avdeling, Regionsykehuset i Trondheim