Geriatrics

Download Cardiovascular Disease in the Elderly by Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich PDF

By Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich

Participants sixty five years of age or older presently account for over 80 percentage of all cardiovascular disease-related deaths. With advances and breakthroughs in glossy medication which are permitting humans to dwell longer, the variety of older adults during this kingdom will keep growing exponentially over the following numerous many years. Cardiologists, geriatricians, and different clinicians taking good care of the aged will require—at the very least—a simple realizing of cardiovascular issues that in general impact the older sufferer. within the Fourth variation of this vintage textual content, every one bankruptcy has been completely up-to-date to supply a finished, but readable review of the epidemiology, pathophysiology, review, and remedy of cardiovascular problems in older adults.Cardiovascular disorder within the Elderly:- offers an in-depth dialogue of the aged sufferer within the scientific atmosphere- considers the influence of a number of coexisting stipulations, frailty, polypharmacy, and sufferer personal tastes in optimizing disorder administration- each one bankruptcy written by way of well-known specialists within the overview and administration of older people with heart problems

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Example text

It has been amply documented that physical conditioning of older persons can substantially increase their maximum aerobic work capacity. 3% mean increase in VO2max (115). The extent to which this conditioning effect results from enhanced central cardiac performance versus augmented peripheral mechanisms, including changes in skeletal muscle mass, varies with the characteristics of the population studied, the type and degree of conditioning achieved, gender, body position during study, and likely genetic factors.

4 years. At long-term follow-up, maximal exercise capacity and maximal heart rate were similar to those of controls, although a higher prevalence of left-axis deviation was found in the group with right BBB (46% vs. 15%, respectively) (157). These findings suggest that right BBB in the absence of clinical heart disease is not rare in older men and reflects a primary abnormality of the cardiac conduction system. Women in the Framingham study demonstrated a lower prevalence of right BBB than men, but had a stronger association of this conduction defect with cardiomegaly and congestive heart failure (152).

Such an association may stem in part from the frequent use of digitalis and various antiarrhythmic drugs by elderly cardiac patients. Much of the reported increased risk attached to these nonspecific repolarization changes is undoubtedly due to the underlying heart disease that necessitated use of these cardiac medications. Even among clinically healthy older persons, however, minor ST-segment sagging or straightening is relatively common, although of questionable prognostic significance. A decrease in the T-wave amplitude with age begins by the fourth decade (140,147).

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