دانلود رایگان مقاله انگلیسی ورم ریوی و نارسایی قلب دیاستولیک در دوره بعد از عمل - هینداوی 2018

Heart failure with preserved ejection fraction (HFPEF) is a diagnosis encountered with increasing frequency in the aging population. We present a case of postoperative pulmonary edema in 63-year-old male with HFPEF. This patient highlights the gap in risk stratification with respect to diastolic heart failure.

3. Discussion

Our patient with postoperative pulmonary edema due to HFPEF serves to highlight a gap in preoperative risk stratification. He attended our preoperative clinic but due to his excellent functional status and resolved HF did not meet criteria for further work-up. The combination of significant fluid shifts and the hyperadrenergic state associated with perioperative stress unmasked his true cardiac deficit with resultant episodes of pulmonary edema. In reflection, is there anything more that could have been done to recognize his increased risk for cardiac complications?

HFPEF is a well-described entity with prevalence ranging from 1.1 to 1.5% [3]. Studies have reported mixed results for perioperative risk in patients with HF and preserved LVEF [4]. In a recent meta-analysis, patients with HFPEF had a lower all-cause mortality rate than did those with HF and reduced LVEF [5]. However, the absolute mortality rate was still high in patients with HF and preserved LVEF as compared with patients without HF. There is limited data on perioperative risk stratification related to diastolic dysfunction and perioperative HFPEF has traditionally been underestimated and not well described in literature.