Cardiac disorders: a guide to assessing risk in the elderly.
Coronary artery disease can have various clinical manifestations, from the presence of "silent" ischemia to the occurrence of an acute myocardial infarction and congestive myopathy. At each point in the clinical manifestation of coronary artery disease, the practitioner has an evolving number of techniques available to guide decisions regarding prognosis and therapy. Guidelines exist for defining which patients with "silent" ischemia need further evaluation. The clinically manifested occurrence of angina pectoris is commonly encountered in the elderly. Prognostic stratification can occur using both invasive and non-invasive techniques. Even patients with unstable angina have different outcomes depending upon clinical presentation and therapeutic management. Finally, a large pool of patients who survive an acute myocardial infarction have a varied prognosis depending upon certain risk markers as documented with widely available non-invasive testing. This article summarizes the evaluations and decisions the physician can make regarding patients who present with the various manifestations of coronary artery disease and provides a summary of recent data supporting decisions regarding prognosis and therapy.
Smith
L K
LK
Preventive Medicine Program, Arizona Heart Institute, Phoenix.
D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000628:therapy; D000789:Angina, Unstable / Q000175:diagnosis / Q000628:therapy; D003327:Coronary Disease / Q000175:diagnosis* / Q000628:therapy; D005080:Exercise Test; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy; D011379:Prognosis