[Heart failure in the elderly. Characteristics of diagnosis and therapy]

The incidence and prevalence of cardiac insufficiency increases dramatically in the elderly. The reason for this is the more frequent cardiac disease in this age group, the functional effects of which compound the sequence of the physiological aging and exogenous noxae. The clinical presentation of heart failure in the elderly may be atypical, echocardiography should always be performed to confirm the diagnosis and obtain a better evaluation of the underlying condition, before therapeutic measures are initiated. For, in the elderly in particular, treatment must be planned on an individual basis. Primarily, reversible cardiac or extracardiac disorders, potential triggers of cardiac insufficiency, must be identified and treated. All the data currently available indicate that in the elderly, too, all the established options for specific treatment should be utilized. While the reservations often applied to the use of drugs to treat chronic cardiac insufficiency--in particular the treatment of acute myocardiac infarction by thrombolysis or acute intervention--and based on a fear of iatrogenic complications, are understandable, but to date do not justify such a stance. Although contraindications in the elderly are more common and complications not always avoidable, old patients can also benefit from these therapeutic measures.