Ask a doctor: Grandma is 89 years old. Now she has shortness of breath, pulmonary edema, heart failure, brain atrophy, cerebral infarction, cerebral arteriosclerosis, and body edema. She was hospitali

Ask a doctor: Grandma is 89 years old. Now she has shortness of breath, pulmonary edema, heart failure, brain atrophy, cerebral infarction, cerebral arteriosclerosis, and body edema. She was hospitalized for 10 days before.

I am studying medicine. First of all, it is necessary to clarify the cause of heart failure. There are many causes of heart failure, such as ischemic heart disease, hypertensive cardiomyopathy, pulmonary heart disease, various cardiomyopathies, etc.

After the cause of the disease is clarified, treatment must be targeted at the primary disease. For example, if it is caused by coronary heart disease and myocardial ischemia, or due to a previous myocardial infarction, then coronary artery expansion must be targeted. In addition, ACEI drugs (low-dose beta-blockers when cardiac function allows) are also used to improve ventricular remodeling; if it is pulmonary heart disease, then tiotrop may be needed to target the primary disease in the lungs. Ammonium bromide and Symbicort/Seretide are drugs for lung diseases. In short, treatment of the primary disease is fundamental.

If heart failure has already occurred, treatment of the heart failure itself is also crucial. Can relieve patient's symptoms. Excessive water and sodium retention in the body can be relieved through diuresis. However, it is necessary to be sure to ensure effective circulating blood volume. Blood pressure cannot be low. Under the condition of ensuring hemodynamic stability, diuresis can be achieved as follows, and the effect will be better: 1-2 furosemide tablets, taken orally on a single day; 2-4 hydrochlorothiazide, taken orally on two days; at the same time, potassium supplement: chloride Take 2 potassium sustained-release tablets three times a day. Digoxin can be taken as half a tablet per day, 0.125 mg.

For senile brain problems, intravenous drip medicine is probably just psychological comfort. Her brain problems are mainly related to age, and there are not many organic diseases. After all, I can't improve much as I get older. But if heart medicine is used properly, the effect can be very obvious.

Laboratory indicators that need attention: Is the blood potassium low? Is there pulmonary hypertension on echocardiogram? What is the left ventricular EF value? Is D-dimer high? Is the infection under control? How many ml is the daily urine output? How much is the daily urine output? Is it more or less than the intake (food conversion calculation and infusion volume)? For patients with heart failure, the output is required to be greater than the intake. Additionally: What is this patient's renal and liver function?

As for the question you asked, how long it will last, it is difficult to speculate. The key depends on whether there is active and appropriate treatment, as well as family care and following the doctor’s recommendations, such as measuring urine volume. etc.