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[Chronic cardiac insufficiency in the elderly]

D Fischer1, A Dettmer-Flügge, R Thiesemann

  • 1Klinik für Kardiologie und Angiologie, Zentrum Innere Medizin, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, Hannover, Germany. Fischer.Dieter@mh-hannover.de

Zeitschrift Fur Gerontologie Und Geriatrie
|May 17, 2011
PubMed

Insights

Heart failure, particularly diastolic dysfunction, increases with age. Geriatric patients require individualized treatment plans considering comorbidities and medications for optimal outcomes.

Area of Science:

  • Cardiology
  • Geriatrics
  • Internal Medicine

Context:

  • Chronic heart failure (CHF) incidence and diastolic dysfunction prevalence rise with age.
  • Geriatric patients often present with less specific symptoms like fatigue, complicating diagnosis.
  • Multimorbidity is common in older adults, impacting treatment decisions.

Purpose:

  • To review the diagnosis and management of chronic heart failure in the geriatric population.
  • To highlight the challenges and considerations specific to older adults with heart failure.
  • To provide guidance on therapeutic strategies and surgical interventions for elderly patients.

Summary:

  • Diagnosis and classification of heart failure in the elderly follow standard guidelines, despite less specific symptoms.
  • Pharmacological therapies (ACE inhibitors, ARBs, aldosterone antagonists, diuretics, digoxin) require careful individualization due to comorbidities and polypharmacy.
  • Cardiac surgery and interventional procedures can be safely performed in patients over 75 after thorough individual risk assessment, as traditional scores may overestimate operative risk.

Impact:

  • Improved understanding of age-related heart failure management.
  • Guidance for clinicians on tailoring therapy for older adults with CHF.
  • Evidence supporting the safety of cardiac interventions in select elderly patients.

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