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Calcific aortic stenosis in the elderly: a brief overview
Neil Sawhney1, Alborz Hassankhani, Barry H Greenberg
1Division of Cardiology, Department of Medicine, University of California San Diego, UCSD Medical Center, San Diego, CA 92103-8411, USA.
Insights
Aortic stenosis is common in older adults, presenting unique diagnostic challenges and treatment considerations. This review covers its causes, symptoms, and management in the elderly population.
Area of Science:
- Cardiology
- Geriatrics
- Valvular Heart Disease
Background:
- Aortic stenosis (AS) is the most prevalent valvular heart disease in individuals over 65.
- Diagnosis and management of AS in the elderly present distinct challenges compared to younger populations.
Purpose of the Study:
- To review the pathophysiology, clinical presentation, and management strategies for aortic stenosis specifically in elderly patients.
Main Methods:
- Literature review focusing on studies and guidelines related to aortic stenosis in geriatric populations.
- Analysis of differences in etiology, clinical findings, and treatment approaches.
Main Results:
- Classic physical examination findings for AS may be diminished or absent in older adults, complicating diagnosis.
- Comorbidities in the elderly often lead to hesitation in recommending aortic valve replacement, despite poor outcomes with medical management.
Conclusions:
- A comprehensive understanding of age-related differences in aortic stenosis is crucial for accurate diagnosis and effective management in the elderly.
- Tailored treatment strategies are necessary to address the complexities of AS in geriatric patients, balancing risks and benefits.
Abstract:
Aortic stenosis is the most common valvular lesion in patients above the age of 65. The etiology, presentation, and management of aortic stenosis differs in the elderly compared to younger patients in many ways. Many of the classic physical findings are absent in the elderly, making the diagnosis of critical aortic stenosis more difficult. Due to coexisting morbidity in many elderly patients, there is often a reluctance to recommend aortic valve replacement despite the dismal prognosis of medical therapy. In the following review, the authors discuss the pathophysiology, presentation, and management of aortic stenosis in the elderly.