Cardiopathy of aging: are the changes related to congestive heart failure?

Over the years, hemodynamic stresses and biologic changes bring about reduced cardiac function. The addition of one or more types of organic heart disease leds to further deterioration of fuction. This is why elderly patients require special consideration and management, why their clinical manifestations and therapeutic responses differ from those in young patients. Although no single abnormality characterizes the aging process, cellular, functional, and structural changes support the existence of a cardiopathy. However, there are insufficient data to link so-called senile cardiopathy directly to otherwise unexplained heart failure. Failure is usually due to the typical reasons, i.e., coronary artery or valvular disease, hypertension, amyloidosis, and chronic pulmonary lesions. Nevertheless, the possibility of senile heart failure should not be overlooked in case of impending or actual myocardial failure. In patients over 60, edema, dyspnea, or tachycardia cannot always be attributed to heart disease. It is hazardous to diagnose and prescribe treatment for cardiac failure if the heart shadow is not enlarged on the x-ray,the circulation time is not prolonged, and the heart sounds and rhythmare normal. Other reasons for the complaints should be looked for, even when the heart rate is fast.