title: Poor tolerance of beta-blockers by elderly patients with heart failure.
abstract: Despite the well-understood importance of beta-blocker therapy in heart failure, it is sometimes not possible to use beta-blockers in elderly patients due to poor tolerance. In this report, we describe the case of an 83-year-old patient with severe systolic heart failure complicated by aortic valve stenosis and atrial fibrillation. A simple therapeutic approach involving discontinuation of beta-blockers remarkably alleviated the symptoms such as left ventricular ejection fraction, and improved the chest radiography and laboratory findings; further, atrial fibrillation converted to sinus rhythm. It is important to carefully administer beta-blocker therapy to elderly patients with heart failure, especially after considering cardiac output.
authors.affiliation: Department of Cardiology, Okazaki City Hospital, Aichi, Japan. pinponstar@yahoo.co.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yanagisawa
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Suzuki
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Tanaka
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D001241:Aspirin / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000188:drug therapy; D017298:Bisoprolol / Q000627:therapeutic use*; D001919:Bradycardia / Q000139:chemically induced; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D011788:Quality of Life; D011859:Radiography; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D004232:Diuretics; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin; D017298:Bisoprolol