[Angina pectoris--particular aspects in the elderly].
The incidence of the coronary heart disease increases dramatically with age, representing in Portugal the second largest cause of death in patients older than 65 years. The cause of this high prevalence of the disease is not completely understood, but the pathogenic role of the cardiovascular risk factors has a singificative importance. It seems to be essential, even in elderly, to control these risk factors in order to limit the progression of the atherosclerotic disease. Regarding symptomatology, effort dyspneia appears to be one of the most frequent disease manifestations, differing from the typical chest pain presentation observed in the younger patients. Exercise stress testing can be used safely in the elderly and it is not just an important diagnostic tool, but it is also essential to the stratification of the patients to be more agressively treated. Concerning treatment, the search and correction of the precipitating factors are a key to success in the elderly patients. Pharmacologic therapy must be prescribed in agreement with the clinical pharmacologic principles, carefully adjusted to the elderly, in order to avoid adverse drug effects. In spite, coronary bypass surgery has some higher risk in the elderly. The results obtained are satisfactory, and the patients subset with ventricular disfunction, benefit the most. Percutaneous transluminal coronary angioplasty constitutes a very atractive therapeutic modality in the elderly. Cardiac reabilitation programe are very useful in the elderly, contributing to the desired psycosocial reintegration of these patients.
Carvalho
M
M
Servico de Medicina IV, Hospital de Santa Maria, Centro de Cardiologia da Universidade de Lisboa.
Carrageta
M
M
D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
Angina de peito--aspectos particulares no idoso.