Highlights the need for age-specific approaches in recognizing and diagnosing coronary heart disease in the elderly due to physiologic changes and atypical presentations.
Supports age-adjusted CHD diagnostic thresholds in older adults; leaves open prospective validation of modified criteria.
Coronary heart disease is a major cause of morbidity and mortality in the older population. The recognition of such disease in the elderly varies in a number of parameters from that noted in younger patients. There are a number of physiologic changes in cardiac function as a result of aging, and they have an important bearing on the recognition of cardiac disease in the elderly. This review stresses the particular features of coronary disease in the aged and contrasts them with features more readily recognized in younger patients. Changes in the development of angina pectoris, heart failure, and the diagnosis of myocardial infarction vary significantly in the elderly population. The role of diagnostic modalities varies considerably in sensitivity and specificity when comparing younger and older patients. Potential areas for further research are stressed.
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Eugene L. Coodley (1988) studied this question.
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