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Cardiovascular Disease in the Elderly

Coronary Artery

Diseases of Aortic Valve

Diseases of Mitral Valve

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.

Cardiovascular Disease

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.

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 kidney’s ability to dispose of sodium and water, which can eventually lead to kidney failure. Once CHF is treated, the kidney’s 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.

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