title: The special problems of heart disease in old people.
abstract: The major difference between heart disease in the old and the young is that elderly people almost have one or more other major, even life-threateninng conditions. These associated diseases challenge the physician in establishing a diagnosis and prognosis, understanding the pathogenesis of the symptoms and signs, and determining the best managemnt. Another important difference is that old persons have senescent changes in all organ systems, whether the heart is normal or diseased. Dyspnea, especially on exertion, is common, and so is edema of the feet and ankles. Chest x-rays show changes typical of old age, e.g., small lung fields, mild to moderate pulmonary fibrosis, and calcium plaques in the aorta. In the absence of cardiac disease, the heart is normal in size or even small. Translationg experience in managing heart disease in young patients to elderly patients must be done cautiously. Old people tend to be confused, delicate, mentally and physically slow, feeble, and unreliable, and they are more sensitive to most-if not all-drugs, especially digitalis. The physician should see them often and question them routinely about their symptoms, signs, and medication. Decisions on management should not be hurried, except in an emergency situation.
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging; D004071:Digitalis Glycosides / Q000009:adverse effects / Q000627:therapeutic use; D004487:Edema / Q000150:complications; D004562:Electrocardiography; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D009206:Myocardium / Q000473:pathology; D011859:Radiography
chemical_list: D004071:Digitalis Glycosides