Description
In the elderly population, coronary artery disease may
present with angina pectoris, but often presents in less typical
ways. Patients can be evaluated by treadmill testing or myocardial
perfusion scanning and left ventricular function can be assessed
by echocardiography or nuclear scanning. Several drug treatments
are available, including b-blockers,
calcium antagonists, nitrates, potassium channel openers,
angiotensin converting enzyme inhibitors, statins and anti-platelet
agents.
Patients who fail to respond adequately to medication
or who are at high risk should undergo cardiac catheterisation
with a view to myocardial revascularisation. Coronary angioplasty/stenting
offers symptomatic improvement at an acceptable risk if patients
are selected carefully. Coronary artery bypass surgery should
be considered in patients with more advanced disease. Although
the morbidity and mortality of surgery is higher than that
in younger patients, good results can be obtained following
detailed initial patient evaluation.
