Komorbiditäten bei Herzinsuffizienz – Die chronisch obstruktive Lungenerkrankung

Herzinsuffizienz wie auch chronisch obstruktive Lungenerkrankung (COPD) gehören zu den häufigsten Gründen für eine stationäre Krankenhauseinweisung bei älteren Patienten und zu den häufigsten Todesursachen weltweit. Leitsymptome der COPD sind Belastungsdyspnoe, Husten und Auswurf. Da diese Symptome häufig auch bei der Herzinsuffizienz anzutreffen sind, ist eine Unterschätzung der COPD bei herzinsuffizienten Patienten zu vermuten. Da die Herzinsuffizienz aber auch mit obstruktiven Veränderungen in der Spirometrie einhergehen kann, ist gleichzeitig auch eine Überschätzung der COPD-Häufigkeit bei der rein spirometrisch gestellten Diagnose möglich. Die vorliegende Übersichtsarbeit beschreibt die Besonderheiten und Schwierigkeiten bei koinzident vorliegender COPD und Herzinsuffizienz im klinischen Alltag und bietet eine Anleitung zur Diagnostik und Therapie.

Both heart failure and chronic obstructive pulmonary disease (COPD) are found amongst the most frequent reasons for hospitalisation and death in the elderly. Cardinal symptoms of COPD are dyspnea, cough and secretion. These symptoms may also occur in heart failure; therefore under-estimation of COPD in heart failure may be expected. On the other hand, since heart failure may also be associated with an obstructive pattern in lung function testing, COPD might be overdiagnosed in heart failure. This review describes special issues, commonalities and disparities in patients with coincident COPD and heart failure and provides a practical approach how to handle the problem in daily routine.

Key words

Heart Failure - COPD - diagnosis - degrees of severity - betablocker - bronchodilators

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