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Home > Family Health & Lifestyle > Seniors'  Health >  Cardiovascular Diseases

Cardiovascular Diseases


Cardiovascular Disease in the Elderly

Cardiovascular disease is one of the leading causes of Cardiovascular Disease morbidity and mortality today.  Coronary heart disease accounts for 70 to 80 per cent of deaths in men and women in adults over 60 years of age.  Congestive Heart Failure (CHF), is the most common cause of hospitalization in the elderly. Since a significant proportion of the population is and will be elderly, and the morbidity and mortality of cardiovascular disease in this population is so profound, it is important to understand the evaluation and treatment of cardiovascular disease in the elderly.

Congestive Heart Failure

The term "heart failure" sounds alarming, but it does not mean the heart has suddenly stopped working.  Instead, it means the heart has not been pumping as effectively as it should to deliver oxygen-rich blood to the body's cells.
Congestive Heart Failure (CHF) occurs when the heart's weak pumping action results in a buildup of fluid (congestion) in the lungs and other body tissues.

 Highlights

Nutrition

Sleeping   
    (Problems)
    Disorders
   

Cardiovascular 
    Diseases in old     age

Post Retirement     Blues

Related Issues

(Cardiovascular Disease)

  Congestive      Heart Failure

  Coronary Artery

  Diseases of      Aortic Valve

  Diseases of      Mitral Valve

 

 

 

CHF usually develops slowly.  Symptoms may not appear for years, and they tend to worsen gradually over time.  That is the reason why it is most commonly seen in old age. The slow onset and progression of CHF results from the heart's own efforts to deal with its gradual weakening.  The heart compensates by enlarging and by forcing itself to pump faster to circulate more blood.

 

Risk Factors

  • Previous heart attacks

  • Coronary artery disease

  • Hypertension (high blood pressure)

  • Arrhythmia

  • Heart valve disease (especially the aortic and mitral valves)

  • Cardiomyopathy

  • Congenital heart defects

  • Alcohol and drug abuse

Symptoms

If the left side of the heart has not been working well (left-sided heart failure), resulting in the flow of blood and fluid back up into the lungs; patients will experience shortness of breath, fatigue, and persistent coughing (especially at night).  In advanced cases, persons may begin to cough up pinkish, blood-tinged sputum.

If the right side of the heart does not work properly (right-sided heart failure), the slowed down blood flow causes a buildup of fluid in the veins.  The feet, legs, and ankles begin to swell under the increased fluid volume. This swelling is called edema.  Sometimes, edema spreads to the lungs, liver, and the gastrointestinal tract.  Fluid buildup causes patients to urinate more frequently, especially at night when body fluids are more evenly distributed.  Fluid buildup also taxes the kidneys' ability to dispose of sodium and water, which can eventually lead to kidney failure.  Once CHF is treated, the kidneys' function usually returns to normal.

As heart failure progresses, the heart eventually loses its ability to compensate and symptoms arise.  In addition to those listed above, other symptoms may include:

  • Difficulty in breathing or difficulty in lying flat because of shortness of breath.

  • Fatigue, weakness, and an inability to exercise or perform physical activities.

  • Weight gain from excess fluid.

  • Chest pain.

  • Loss of appetite, indigestion.

  • Swollen neck veins.

  • Cold, sweaty skin.

  • Rapid or irregular pulse.

  • Restlessness, confusion, and decreased attention span and memory.

Diagnosis

Most physicians can make a tentative diagnosis of CHF from the presence of edema and shortness of breath.

  • With a stethoscope, a physician can listen to a patient's chest for the crackling sounds of fluid in the lungs, the distinct sound of faulty valves (heart murmur), or the presence of a very rapid heartbeat. Tapping on the patient's chest will reveal if fluid has accumulated in the chest cavity.

  • A chest X ray can reveal an enlarged heart and fluid in and around the lungs.

  • Electrocardiography (ECG or EKG) can be used to check for arrhythmias and cardiac stress, as well as reveal previous heart attacks.

  • Echocardiography can be used to observe valve function, heart wall motion abnormalities, and overall heart size.  

Other imaging techniques such as nuclear ventriculography and angiography can provide a firm diagnosis and reveal the extent of the disease.

Treatment

Studies show that drugs also help improve overall heart function and increase a patient's exercise capacity.  The following classes of drugs are often prescribed:  

  • Diuretics, which help rid the body of excess fluid.

  • Inotropics, such as digitalis and digoxin, which strengthen the heart's ability to pump.

  • Vasodilators, such as nitroglycerine compounds.

  • Calcium channel blockers, which keep vessels dilated and lower blood pressure.

  • Newer beta blockers, which have been shown to help increase exercise tolerance and improve symptoms over time.

  • ACE inhibitors, which decrease blood pressure by inhibiting hormones that negatively impact blood pressure regulation.

Surgical And Interventional Procedures 

Interventional Procedures

  • Angioplasty

  • Stenting

  • Therapy using inotropic drugs, which increase the heart's ability to contract. These drugs are given through a small catheter placed directly in an artery.

Surgical Procedures

  • Heart valve repair or replacement

  • Pacemaker insertion

  • Correction of congenital heart defects

  • Coronary artery bypass surgery

  • Mechanical assist devices

  • Heart transplantation  

The best way to prevent heart failure is to practice healthy lifestyle habits that reduce your chances of developing a heart problem.  It is also important to identify early any risk factors that contribute to heart failure, such as high blood pressure or coronary artery disease.  The vast majority of patients with congestive heart failure can be successfully treated, most commonly with interventional procedures.  Patients should carefully follow their physicians' advice; and in doing so, they can continue to live full and productive lives.

Lifestyle Changes

  • Quit smoking.

  • Control high blood pressure, cholesterol,  and diabetes.

  • Eat a sensible diet that includes moderate caloric intake and restricted salt.

  • Limit consumption of alcohol and fluids, in general.

  • Weigh daily to monitor fluid retention.

  • Start a medically supervised aerobic exercise program

 

 
 

  

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