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Coronary heart disease in the elderly: identifying established and subclinical disease with stress testing

Sheila Sahni1, Prashant Vaishnava, Bruce Darrow

  • 1Mount Sinai School of Medicine, New York, NY, USA.

The Mount Sinai Journal of Medicine, New York
|July 13, 2011
PubMed

Insights

Diagnosing cardiovascular disease in elderly patients, particularly asymptomatic ones, is difficult. Noninvasive testing aids identification, but its long-term impact on outcomes requires further study.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Diagnostic Imaging

Background:

  • Cardiovascular disease (CVD) is a leading cause of death and healthcare costs in the US.
  • Diagnosing CVD in elderly patients, especially asymptomatic individuals, presents significant challenges.
  • Current guidelines lack clarity on the long-term benefits of CVD diagnosis in this population.

Purpose of the Study:

  • To review the utility of noninvasive testing for cardiovascular disease.
  • To evaluate diagnostic approaches in symptomatic, asymptomatic, and pre-surgical elderly patients.
  • To inform clinical decision-making regarding noninvasive CVD screening in older adults.

Main Methods:

  • Literature review of noninvasive cardiovascular testing modalities.
  • Analysis of diagnostic accuracy and clinical impact in diverse patient groups.
  • Synthesis of evidence regarding guideline recommendations and uncertainties.

Main Results:

  • Noninvasive testing can identify cardiovascular disease in elderly patients.
  • Evidence is limited regarding the impact of early diagnosis on long-term outcomes.
  • The role of testing varies between symptomatic, asymptomatic, and pre-operative patients.

Conclusions:

  • Noninvasive testing is valuable for cardiovascular disease detection in the elderly.
  • Further research is needed to clarify the long-term benefits of diagnosis.
  • Tailored approaches are necessary for different patient subgroups.

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