Angina pectoris and silent ischemia in the elderly: a management update

Coronary artery disease accompanied by symptomatic and asymptomatic myocardial ischemia is a common entity in older patients. The pathophysiology of myocardial ischemia is related to an imbalance in myocardial demand and coronary perfusion. Treatment strategies for symptomatic myocardial ischemia include correction of aggravating medical conditions (eg, anemia or hypertension) and the use of nitrates, beta-adrenergic blockers, salicylates, and calcium-entry blockers, alone or in combination. Silent myocardial ischemia is also a prevalent condition in older individuals, with and without angina pectoris. Treatment regimens are similar to those used in symptomatic patients.