Final answer:
Coronary artery disease in the elderly is characterized by reduced blood flow to the heart due to plaque build-up and can present with symptoms like chest pain and shortness of breath. A workup to diagnose CAD may include ECG, stress testing, CCTA, and angiography. Treatment includes medication, lifestyle changes, and possibly surgical procedures.
Step-by-step explanation:
Coronary artery disease (CAD) is a condition characterized by reduced blood flow to the heart muscle due to atherosclerosis, the build-up of plaque in the arteries. Typical symptoms include chest pain or discomfort which may radiate into the shoulder, arm, back, neck, or jaw, often occurring with exercise or emotional stress, and improving with rest. Some patients may experience shortness of breath, or in more severe cases, the first sign may be a heart attack. Other complications can include heart failure or abnormal heart rhythms.
When assessing an elderly patient for CAD, a thorough workup is critical. This could include an electrocardiogram (ECG), cardiac stress testing, coronary computed tomographic angiography (CCTA), and coronary angiogram to diagnose the extent of the disease. The treatment options for CAD may involve a combination of medication, lifestyle changes such as diet and exercise modifications, angioplasty with a balloon catheter, stent insertion, or coronary bypass surgery.
Risk factors for CAD include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol consumption. These risk factors should be managed to prevent progression of the disease, which can begin early in life and progress gradually. Figure 19.16 illustrates how an angiogram can show occluded arteries, which can lead to serious outcomes like myocardial infarction if left untreated.