Characteristics and Management of Coronary Heart Disease in Greek Elderly Patients

Journal of Clinical and Basic Cardiology 2001; 4 (3): 221-223

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Keywords: alter Mensch,  Herzinsuffizienz,  Kardiologie,  Koronare Herzkrankheit,  cardiology,  coronary heart disease,  heart failure,  octogenarians

The aim of our study was to determine the special characteristics of clinical presentation and management of coronary heart disease (CHD) in elderly patients. During a one-year period, 108 consecutive elderly patients, 32 male, 76 female, mean age 83±5 years, range 77?100 years, who were admitted to the cardiology department because of myocardial infarction (MI), stable or unstable angina entered into our study. All patients were examined for other diseases, which contribute to clinical presentation or deterioration of coronary heart disease (anaemia, thyroidopathy). They were treated conservatively with pharmacotherapy and management of possible risk factors, while all patients discharged with advise for further medical examinations (exercise tolerance test, coronary arteriography) and probable interventional and/or surgical treatment of their CHD. 12/108 (11 %) patients admitted with acute myocardial infarction (MI), 84/108 (78 %) patients had stable angina and 12/108 (11 %) had unstable angina. 96/108 (89 %) patients had concomitant symptoms of congestive heart failure (HF) upon admission. At admission, the ECG showed atrial fibrillation in 20 patients, LBBB in 8, RBBB in 12, left ventricular strain in 16, pacemaker pulse in 2, ischaemic lesions in 38 and normal findings in 12 patients. Thorax X-ray revealed HF findings in 58/108 (54 %) patients. Iron deficient anaemia (Ht < 35 %, serum iron < 45 mg/dl, normal values > 50 mg/dl), was found in 36/108 (33 %) patients, while 20/108 (19 %) patients had clinical and laboratory findings of hyperthyroidism and 8/108 (7,5 %) hypothyroidism. 12/108 (11 %) patients had taken blood transfusion. Only two patients agreed to perform bypass, while all the other patients refused further examinations or interventional management of their CHD. In the majority of elderly patients (89 %), CHD manifested with concomitant HF, while the presence of systematic disease, (anaemia 33 %, hyperthyroidism 19 %, hypothyroidism 7,5 %), played a significant role in the clinical manifestation of CHD in this age group. Only two elderly patients agreed to perform bypass, while the rest refused further interventional management of their CHD.