Deutsche medizinische Wochenschrift
-
Heart failure (HF) is the leading cause for inpatient treatment in Germany. Its diagnosis is based on the ESC Guidelines for Diagnosis and Treatment of Heart Failure of 2016. More than half of all patients with HF suffer from HF with preserved ejection fraction (HFpEF), whose diagnosis is still challenging. Two new diagnostic scores have been proposed to facilitate the diagnosis of HFpEF and are presented in this article, the H2FPEF-Score and the HFA-PEFF-algorithm by the Heart Failure Association.
-
Since publication of the European Society guidelines for the diagnosis and treatment of acute and chronic heart failure in 2016, numerous studies provided new evidence how to further optimize heart failure therapy. Besides recent device-based therapeutic options, promising new drug developments give a glimmer of hope that the prognosis of this progressive heart disease could be somehow more controlled in the near future. At the same time, the variety of therapeutic options as well as the number of concomitant comorbidities makes the complex therapy of chronic heart failure more difficult than ever. This review aims to provide an update and practical support on the recent pharmacotherapeutic options in chronic heart failure.
-
Sarcopenia is characterized by a generalized loss of muscle function, strength and mass and is codable in Germany since 2018 in the ICD-10-GM (M62.50). For screening in primary care, it is possible to determine muscle function and strength by means of a sarcopenia questionnaire (SARC-F) as a self-filler with 5 questions of restrictions. With an increased score of 4 and higher, an examination of the musculature and a determination of the skeletal muscle mass index should be performed via dual energy X-ray absorption measurement (DXA) or bioelectric impedance analysis (BIA). ⋯ The severity of the disease is defined by additional examinations such as gait speed, timed up and go test (TUG) and/or short physical performance battery (SPPB). Patients with sarcopenia suffer from increasing immobility and disability and have an increased risk of falls, fractures and mortality. Frequently, co-morbidities should be clarified in all affected patients.
-
We report the case of a 27-year-old Syrian patient who came to the emergency department with a syncopal episode. No medical history could be raised due to a language barrier and so the clinical presentation was leading. ⋯ Obscure clinical symptoms alongside signs of shock, should always considered to be an allergic reaction in absence of sepsis or hemorrhage. In anaphylaxis, echinococcosis should always be included in the differential diagnosis.