Complicating Factors in Elderly Patients with Heart Disease

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Elderly patients constitute a high percentage of patients with myocardial infarction,heart surgery, and percutaneous transluminal coronary angio-plasty (PTCA). Elderly patients are also at high risk of disability following a cardiovascular event (Table 47-2). The prevalence of diabetes and arterial hypertension is relatively high. There is also an increased incidence of complicated forms of coronary disease such as multi-vessel disease and left main coronary artery disease, severe and unstable angina as well as sinus node dysfunction, conduction disturbances, and heart failure. The risk of complications is increased in elderly patients after myocardial infarction, coronary angiography, PTCA, and surgery of the heart or the thoracic aorta. The duration of hospitalization is usually prolonged. Severe deconditioning may be a consequence of prolonged immobility. The risk of neurological complications and also of cognitive defects after heart surgery is increased. There is also a high incidence of co-morbidities. The rate of negative side-effects of medications is increased. Degenerative changes of the muscu-loskeletal system may add to the difficulties which may be encountered during follow-up and rehabilitation of such patients.

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