Geriatric Cardiology: Diagnostic exercise testing in older patients

In this issue, Drs. vom Eigen and Ades review diagnostic exercise testing in older subjects. For those older patients who can exercise to a sufficient heart rate, the diagnostic accuracy of stress testing is comparable to that observed in younger patients. For patients with physical or psychological limitations to exercise, intravenous dipyridamole in conjunction with myocardial imaging by echocardiography or with thallium-201 provides an excellent alternative to traditional stress testing. Dr. Rich then reports on two recent studies describing the long-term outcome of patients with congestive heart failure and preserved left ventricular function. The data suggest that these patients are subject to significant morbidity and mortality during 4 to 7 years of follow-up. Following the study reports is an annotated bibliography of recent literature relevant to cardiovascular disease in the elderly, a report from the Council on Geriatric Cardiology, and a calendar of upcoming programs and events in cardiology.