Provides a general overview of coronary artery disease presentations, distinguishing between chronic stable angina and acute coronary syndromes in elderly patients.
Aids differentiation of CAD presentations in elderly patients; extends descriptive literature but leaves open needs for prospective outcome studies.
Coronary atherosclerosis is a nearly universal finding in people over 75 years old living in developed countries, but is often sub-clinical. Broadly speaking, symptomatic patients manifest coronary artery disease in two distinct ways: chronic stable angina or an acute coronary syndrome. Stable angina produces symptoms of exertional chest pain due to fixed atherosclerotic narrowing of the coronary artery, and requires chronic therapy. In contrast, the acute coronary syndromes, namely acute myocardial infarction (MI) and unstable angina, occur as a result of plaque rupture or erosion leading to acute coronary arterial thrombosis and occlusion that requires emergency hospitalization and treatment.
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Cowell et al. (2004) studied this question.
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