プライマリケアで診る慢性心不全

出版社: 中外医学社
著者:
発行日: 2022-12-25
分野: 臨床医学:内科  >  循環器一般
ISBN: 9784498136786
電子書籍版: 2022-11-25 (1版1刷)
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75歳以上の後期高齢者が急増する2025年を間近に控え,75歳以降有病率が急上昇する「心不全パンデミック」もまた懸念されています.従って,生活習慣病を心不全に進展させない管理,発症した心不全を増悪させない管理がプライマリケア医にとって重要な役割になってきます.
本書では心不全の基礎知識・分類・検査・診断・薬物治療・外来管理・併存疾患管理など,プライマリケアに役立つ心不全の知識を幅広く解説します.

目次

  • ■I  基礎編
    1.心不全の基礎知識
    (1)心不全パンデミックとプライマリケア医の役割
    (2)心不全の定義と疾患概念
    (3)病態生理
    (4)自覚症状と身体所見
    2.心不全の検査と診断
    (1)心不全の診断
    (2)BNP,NT-proBNP
    (3)血液検査
    (4)胸部X線
    (5)心電図
    (6)心エコー図
    3.心不全の分類
    (1)複数の切り口による病型分類で病態の理解を深める
    (2)慢性心不全の重症度分類
    (3)血行動態に基づく心不全の分類 ~治療方針の指針~
    4.心不全治療の総論
    (1)慢性心不全の治療
    (2)急性心不全の初期対応
    5.治療薬各論
    (1)ACE阻害薬/ARB
    (2)ARNI
    (3)β遮断薬
    (4)ミネラルコルチコイド受容体拮抗薬(MRA)
    (5)利尿薬
    (6)SGLT2阻害薬
    (7)イバブラジン
    (8)sGC刺激薬(ベルイシグアト)
    (9)硝酸薬
    (10)ジゴキシン

    ■II  実践編
    6.慢性心不全を悪化させない外来管理
    (1)血行動態からみる心不全の悪化とは?
    (2)患者さんのセルフケア
    (3)診察室での血行動態チェック
    (4)プライマリケア医が行う心不全増悪時の対処
    (5)どのタイミングで専門医に紹介するか?
    (6)心不全患者さんを病院から紹介を受けたときに行う作業
    (7)心不全入院退院後に直接紹介を受けたときはさらに注意が必要です
    (8)高齢者心不全の特徴と注意
    (9)心不全の訪問診療
    7.併存疾患の管理
    (1)高血圧症
    (2)糖尿病
    (3)心房細動
    (4)慢性腎臓病
    (5)虚血性心疾患
    (6)貧血と鉄欠乏
    (7)心臓弁膜症
    (8)COPD・気管支喘息
    8.日常生活の管理
    (1)クリニックで行う患者指導と多職種介入
    (2)フレイルと心臓リハビリテーション
    (3)心不全の栄養管理
    9.心不全の緩和ケア
    (1)アドバンスケアプランニングの実施
    (2)緩和ケアの導入
    (3)症状と薬物療法

    ■III  Q & A編
    (1)患者さんからの質問
    (2)メディカルスタッフからの質問
    (3)非専門医からの質問

    【コラム一覧】
     1.心不全では血圧が低くても,降圧薬を安易に中止してはいけない理由
     2.病態生理から考える心不全の治療薬
     3.夜間頻尿の鑑別
     4.足のむくみの鑑別 ~治療の必要性をどう判断する?~
     5.ステージBの心不全をどうみつけて,どう管理する?
     6.HFrEF治療のパラダイムシフト ~The fantastic four~
     7.心不全が悪化したときにβ遮断薬を中止してはいけない?
     8.経口薬と静注薬でフロセミドの使い分けは? 効果の比較は?
     9.何をみて利尿薬の量を調整するのか?
    10.トルバプタンを継続内服している患者さんが病院から紹介されたときの注意点
    11.心不全患者の至適血圧の考え方
    12.患者さんを診るうえで大切なこと ~看護師・心不全療養指導士の視点から~

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

I 基礎編

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P.78 掲載の参考文献
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II 実践編

P.106 掲載の参考文献
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P.125 掲載の参考文献
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3) Sciarretta S, Palano F, Tocci G, et al. Antihypertensive treatment and development of heart failure in hypertension : A Bayesian network meta-analysis of studies in patients with hypertension and high cardiovascular risk. Arch Intern Med. 2011 ; 171 : 384-94.
4) Davis BR, Piller LB, Cutler JA, et al. Role of diuretics in the prevention of heart failure : the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Circulation. 2006 ; 113 : 2201-10.
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7) Yusuf S, Pfeffer MA, Swedberg K, et al ; CHARM Investigators and Committees. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction : the CHARM-Preserved Trial. Lancet. 2003 ; 362 : 777-81.
9) Cunningham JW, Vaduganathan M, Claggett BL, et al. Effects of sacubitril/valsartan on N-terminal pro-B-type natriuretic peptide in heart failure with preserved ejection fraction. JACC Heart Fail. 2020 ; 8 : 372-81.
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III Q & A編

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