[Heart failure in the elderly]

The prevalence of coronary insufficiency increases with age and constitutes the leading cause of mortality. However, due to a wide range of clinical and electrical atypical presentations, its diagnosis is most often overlooked contributing to many wandering diagnostic and inadequate therapies. The fear of adverse events leads to the fact that elderly patients are most often under-treated in both situations, chronical and acute. In 2008, the diagnosis of coronary artery disease in the elderly must use all modern means: stress test with thallium scintigraphy, stress echocardiography, computed tomography and even coronary angiography which risk of morbidity and mortality is currently very low due to a lot of therapeutic advancements. The age alone should not represent contra-indication to any of our medications, even the most aggressive, always keeping in mind that the risk/benefit ratio is always favourable due to the high risk of major cardiovascular events in the elderly population.