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This book provides an in depth review of the current practice in treating elderly patients with coronary artery disease (CAD) as well as an update of the existing literature. It is intended to reflect the current science of elderly patients with stable angina, acute coronary syndromes and those patients who are forwarded for CAGB procedures. Evidence in the elderly patient group is often limited and/or non-existent therefore the main challenge, even for further research, will be to define the role of geriatric preconditions and its impact on outcome. A second topic will be to clarify how, if ever, existing cardiological outcome values like mortality can be applied to elderly patients or if other values like improvement of functional status or quality of life are more suitable parameters to measure interventional success in elderly patients. The role of pharmacotherapy in advanced age has to be discussed. These topics will be embedded in epidemiological, pathophysiological and ethical aspects of interventional treatment of CAD in older age.
CARLO CONTI You are today confronting sensitive questions on the subject of "Cardiac surgery and heart diseases in old age" and I congratulate you on this. It is a brave and important step to discuss this multifaceted question which demands an answer and an explanation from many perspectives: From a medical perspective, there is the question of the medical feasibility and durability of treatment. From an economic angle we ask ourselves whether we can pay for everything that is medically feasible. From the patient's perspective there is the legitimate de sire and the justified need not to leave anything untried that might serve to sustain or improve the quality of life. The ethical perspective: is what is feasible really desirable? Should everything be done simply because it can be done? Is it ethically acceptable to set an age limit on an opera tion that in all probability will produce an improvement in the quality of life? And if so, where does this limit lie? Below it surgery is "worthwhile" but above it is not? No one in all seriousness and with a clean conscience will want to draw this line randomly or arbitrarily. That ap pears to us - quite rightly - morally unacceptable. The doctors' perspective: they are obliged by the Hippo cratic oath in principle to carry out all the treatments that are indicated and comply with the rules of the art of med ICIne.
The second edition of this book updates, reviews, and discusses the latest findings on the pathophysiology, diagnosis, and management of cardiovascular disease in the older patient. It explains the physiological changes associated with the normal aging process that may lead to the development of disease, to adverse consequences once disease develops, and which alter the risk-benefit equation for medical and other interventions designed to diagnose, assess, and treat cardiovascular disease. Chapters address key issues in the management of cardiovascular disease in the elderly including prevention, coronary artery disease, valvular disease, hypertensive disease, arrhythmias, and interventions. Wherever possible, the authors take an evidence-based approach to recommendations and rely heavily on clinical trials. The value of lifestyle changes in the aging population, the use of primary and secondary prevention strategies, treatments, and complications are also discussed. Cardiovascular Disease in the Elderly offers physicians and other related providers who care for older patients a gold-standard approach to understanding and managing cardiovascular disease in this group.
This book focuses specifically on the management of cardiovascular disease in elderly patients with particular frailties and in the “oldest old”. It is clearly explained how treatment in these patients differs from that in patients in their seventies who respond well to therapies and do not present frailties or organ failures. Although not young, the latter patients can be treated almost like any other patient, according to established guidelines. In contrast, the frail, compromised elderly and the oldest old require specific measures that target their needs, including with respect to underlying renal conditions. The book considers all those pathologies that have a high prevalence in the general population, explaining advanced treatment concepts and all aspects of assessment. Key clinical points are highlighted, and the text is supplemented with numerous informative figures and tables. The authors are respected experts, for the most part geriatric physicians, and the book is especially addressed to cardiologists, who may lack the described targeted information and treatment tools.
Reviews the best therapies and surgical techniques available to provide quality care for the elderly cardiac patient and of those areas that require further research. The authors detail preventive therapies and the cardiovascular syndromes that disproportionately afflict the older individual, including arrhythmias (particularly atrial fibrillation), syncope, heart failure (particularly diastolic heart failure), and ischemic heart disease. They also delineate the surgical management of the heart patient with discussions of postoperative management and its complications and of specific surgical procedures such as coronary artery bypass grafting, valve surgery, pacemaker and defibibrillators, and surgical management of heart failure.
This issue of Heart Failure Clinics, edited by Drs. Wilbert Aronow and Ali Ahmed, will cover a wide array of topics related to Heart Failure in Older Adults. Subjects covered include, but are not limited to: Epidemiology, Pathophysiology, and Prognosis of Heart Failure in the Older Adult; DEFEAT Heart Failure: Clinical Manifestations, Diagnostic Assessment, and Etiology of Geriatric Heart Failure; Heart Failure with Preserved Ejection Fraction in the Older Adult; Heart Failure—Complicating Acute Myocardial Infarction; Interventional Therapies for Heart Failure in the Older Adult; Cardiac Resynchronization Therapy for Treatment of Heart Failure in the Older Adult; and Left Ventricular Assist Devices in Treatment of Heart Failure in the Older Adult, among others.
Coronary artery disease (CAD) causes severe disability and more death than any other disease in affluent societies, including cancer. The medical conditions associated with it are angina, ischaemia, unstable angina, myocardial infarction, arrhythmias, heart failure and sudden death. Choosing the appropriate investigation to confirm a diagnosis helps to assess risk and determine the correct treatment path. GPs also need to know the effective life-style and risk-factor modifications in addition to advocating the best medical therapy.
Interventional Cardiology is an extensive, richly illustrated guide to this field of medicine. The book is edited by internationally recognised experts, led by Professor Samir Kapadia. This book provides comprehensive coverage of all aspects of interventional cardiology, across five sections, further divided into 88 chapters. The first section covers the evolution periprocedural pharmacology, beginning with chapters on the history of coronary intervention and concluding with clinical cases. The second section covers specific coronary interventions, taking either a disease-based or an anatomical approach. The chapters also provide information on individual patient groups, such as the elderly and diabetics. Detailed chapters on a range of devices used in interventional cardiology are included in this section. Further sections cover a wide range of peripheral and structural interventions, and the final chapter on general topics includes radiation protection, prevention and management of bleeding, and haemodynamic essentials. Enhanced by 700 full colour images, Interventional Cardiology is an authoritative resource for all cardiologists. Key Points Comprehensive, illustrated guide to interventional cardiology Edited by internationally recognised experts led by Prof Samir Kapadia 700 full colour images
Written and edited by today's most-recognized inteventional cardiology thought leaders, this popular guide focuses on key procedures and techniques. Each strategic or tactical move is graded by complexity level and described in a simple, step-by-step approach that includes guidance on how to overcome practical difficulties and navigate particularly challenging clinical scenarios and complications. It offers interventional cardiologists, fellows in interventional cardiology, cath lab nurses and technicians; vascular surgeons and fellows, interventional radiologists: "Tips and tricks" gathered from the personal experience of over fifty international experts Clear, practical, step-by-step guidance on the latest procedures and techniques, performing challenging interventions, and managing complications and other difficult situations where evidence may be limited or inconsistent New coverage of hot topics such as percutaneous aortic valve replacement, renal artery ablation, intracranial interventions, and more
Continued advances in cardiology have led to unprecedented scientific progress in recent years. However, no matter how advanced the science, the successful application of interventional cardiology relies upon a practitioner’s ability to approach interventional techniques competently and confidently in every situation. Fully updated and featuring new chapters and additional tips and tricks, this latest edition of Dr Nguyen, Colombo, Hu, Grines, and Saito’s celebrated book provides a complete yet concise guide to practical interventional cardiology that deserves a place in every cardiac laboratory. Culled from the personal experience of over fifty international experts, the book incorporates more than 500 practical tips and tricks for performing interventional cardiovascular procedures. Each strategic or tactical move is graded by complexity level and described in a simple, step-by-step approach that includes guidance on how to overcome practical difficulties, providing a comprehensive resource that can benefit both beginner or experienced operators. As well as covering the latest developments in interventional cardiology, this third edition includes technical tips that promote user-friendly performance, low complication rates, cost- and time-efficient approaches and cost- and time-effective selection of devices to help optimize the practice of modern interventional cardiology.