Article information
Resumen
El envejecimiento progresivo de la población y el aumento de supervivencia de los pacientes con cardiopatía e hipertensión arterial, gracias a las mejoras en su tratamiento, están provocando un incremento de la prevalencia de insuficiencia cardíaca, sobre todo en ancianos.
En el manejo de los pacientes ancianos con IC, los cardiólogos utilizan los recursos diagnósticos y siguen las guías publicadas y los resultados de los ensayos clínicos con más frecuencia que otros médicos. Los estudios sugieren que los pacientes se benefician del manejo por parte de especialistas en cardiología, obteniendo una mejor calidad de vida y menos reingresos hospitalarios, aunque todavía no está demostrada de manera definitiva la ventaja de los cuidados cardiológicos en el pronóstico.
Sin embargo, debido en gran parte a causas logísticas, la mayoría de estos pacientes deben ser vistos por médicos no cardiólogos. En otros casos, la presencia de otros factores como una comorbilidad importante, indican un manejo preferente por médicos geriatras, internistas o de asistencia primaria. En estos casos los cardiólogos deben implicarse más como soporte de los demás médicos tanto en la fase aguda como en el seguimiento a largo plazo. Un enfoque multidisciplinar que incluya una atención médica y no médica parece ser la mejor opción para aprovechar al máximo los recursos que cada especialidad puede ofrecer.
Palabras clave:
Insuficiencia cardíaca
Anciano
Especialidad
Summary
The progressive aging of the population as well as the increased survival of patients with heart disease and high blood pressure, because of improvements in their treatment, are leading to an increased prevalence of congestive heart failure, above all in the elderly.
The cardiologists use diagnostic and therapeutic resources and follow published guides and the results of the clinical trials more frequently than other physicians in the management of elderly heart failure patients. Several studies suggest that elderly patients with heart failure managed by cardiologists would improve more in terms of quality of quality of life and fewer hospital readmissions compared with patients managed by other physicians, although the advantages of cardiology care in the prognosis has not been definitely shown as of yet. However, greatly due to logistic reasons, most of these patients have to be diagnosed and treated by non-cardiologists. In other cases, the presence of other factors such as significant comorbidity or other associated problems lead to preferential management by geriatricians, internal medicine physicians or general practitioners. In those cases, the cardiologists must provide clinical support to the other physicians in both the acute phase as well as during long term follow-up. A multidisciplinary approach, including medical and non-medical care, seems to be the best option that takes advantage of the resources offered by each specialty.
Key words:
Heart failure
Elderly
Specialty
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