Congestive Heart Failure in the Elderly

A conservative and multidisciplinary medical treatment for a centenarian woman with acute coronary syndrome with multivessel coronary disease and heart failure: A case report and literature review

“…As these problems are common among nonagenarians, the management of HF on this patient included a cardiologist, nephrologist, dietitian, pharmacist, and physical therapist, with close and periodical follow-up. This kind of multidisciplinary strategy had been proven to be efficient in the management of HF, 11,14 and it certainly worked on this patient. Physiologically, the oldest population of elderly patients have increased vascular resistance, decreased heart rate, and less heart rate responsiveness despite increased circulating norepinephrine, decreased glomerular filtration rate, and a noncompensatory filtration fraction.…”

“…11 This patient had multiple important predisposing factors of HF: coronary artery disease, hypertension, and valvular heart disease. Later in the clinical course, HF was precipitated by ACS, renal insufficiency, and infection, which are all well-known predisposing and precipitating factors of HF.…”

Echocardiographic analysis of the left ventricular function in elderly runners

“…The systolic and diastolic diameters are higher in elderly athletes, but not significantly different from those of the elderly non-athletes. During aging there is a clear gradual reduction of myocardial relaxation and elastic recoil, resulting in a slow decline of the left ventricular pressure and slow ventricular diastolic filling 3,6 . This study suggests that exercise prevented this physiological decay.…”

“…These cardiovascular changes result from complex interactions of central and peripheral mechanisms operating at structural, electrophysiological, biochemical, metabolic, and neurogenic levels 2,3 . These factors are dependent on the intensity and duration of training, the type of athletic activity, and intrinsic genetic factors.…”

“…Progressive hypertrophy of smooth muscle cells from blood vessels' walls, thickening of the intima-media arterial wall due to collagen deposition, degeneration of elastic fibers, and calcium deposition constitute a plethora of factors that decrease arterial compliance and increase arterial stiffness 1,2 . Beyond the vascular changes, aging is also associated with direct changes in the heart which explain why cardiovascular diseases, especially hypertension, coronary artery disease, and congestive heart failure are so common among the elderly [2][3][4] . In fact, some forms of heart failure are linked to arterial stiffness and systemic hypertension, leading to poor prognosis and increased risk of mortality.…”