Cardiac Management in the Frail Elderly Patient and the Oldest Old by Andrea Ungar download in pdf, ePub, iPad
The longer one waits to initiate a rhythm treatment strategy, the more difficult it is to regain sinus rhythm. Nonspecific symptoms, such as being generally unwell, fatigued, or lethargic, are common manifestations of diabetes in old age. Percutaneous left atrial appendage closure is a new invasive procedure evolving as an alternative to systematic anticoagulation therapy. Geriatric syndromes may be the first manifestation of diabetes, such as falls and urinary incontinence.
Patients need to receive aspirin indefinitely. Elderly patients are prone to injuries and falls, and thus the fear of bleeding is considerable in them. In contrast, the frail, compromised elderly and the oldest old require specific measures that target their needs, including with respect to underlying renal conditions.
Clinicians should be aware that older people may have normal fasting glucose levels in the early stages of diabetes. The incretin hormones normally reduce blood glucose level by inducing glucose-dependent insulin release and inhibition of glucagon secretion.
Evidence for Glycemic Control Tight glycemic control reduces microvascular disease. Therefore, flecainide and propafenone must be given to patients without structural heart disease. Comorbidity Burden Chronic conditions are common among older people with diabetes. Elderly patients often present these characteristics and could benefit from this novel therapy. In old age, diabetes is associated with high comorbidity burden and increased prevalence of geriatric syndromes in addition to the traditional vascular complications.
Abstract The prevalence of diabetes is increasing due to aging of the population and increasing obesity. Antiarrhythmic agents have been associated with serious adverse side effects, particularly the induction of proarrhythmia. In the elderly patients, serum albumin levels often drop dramatically due to inflammation or malnutrition and lack of protein in their diets. Amiodarone is the safest choice in pharmaceutical cardioversion in the elderly. Patients receiving rivaroxaban presented less intracranial hemorrhages and fatal bleeding.
Diabetes is associated with premature morbidity, mortality, and is a substantial health burden on individuals, health systems, and society. The comorbidity burden is even higher in care home residents with diabetes.
Electrical cardioversion requires anesthesia, while pharmaceutical cardioversion requires medication that has serious side effects and contraindications. Therefore, comprehensive geriatric assessment should be performed on initial diagnosis of diabetes. Symptoms could also be atypical, such as anorexia, rather than the typical polyphagia. Methods The authors performed a search of Medline and Embase from January to March using keywords relating to diabetes management in older people. Articles were reviewed for relevance by abstract.
Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Some patients may relapse and so a second procedure will be required in order to maintain normal sinus rhythm. The most common complication of the latter technique is phrenic nerve palsy.
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