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• W2097777237 startingPage "137" @default.
• W2097777237 abstract "The relative prevalence of calcific degenerative valvular disease in patients undergoing surgical intervention has increased dramatically over the past several decades, in part because of longer lifespans and prevention of rheumatic fever. 30 Also, surgical intervention is increasingly used in management of valvular disease in the elderly (Table 1) . 2 , 114 Recognition of valvular disease in elderly patients is hampered by the overlap in symptom profiles between those with and without valvular disease and by the nonspecific physical examination findings in many elderly patients. Symptoms of chest pain, shortness of breath, exercise intolerance, and dizziness are common and have many other potential causes so that valve disease often is not considered in the differential diagnosis. Similarly, since systolic murmurs are so frequent in the elderly, the patient with severe aortic stenosis, but a soft murmur, may be missed. Although it is recognized that surgical in tervention can be performed with an acceptable operative mortality and morbidity in selected elderly patients, the importance of considering comorbid conditions and functional status in surgical decision making in the elderly cannot be overemphasized. 43 , 114 Normal aging changes can substantially impact the ability of the elderly to tolerate cardiovascular surgery, so benefits of surgery with regard to symptom relief and improved survival must be balanced against the surgical risk, keeping in mind that surgical morbidity (e.g., cerebrovascular events) may be of even more concern than surgical mortality rates (Fig. 1) . Clearly, the elderly patient should be fully informed and involved at every stage of the decision-making process. Although there is increasing data to make evidence-based decisions on the elderly patient with valvular disease, there are still many areas of uncertainty. Thus, patient management remains a complex task requiring a highly individualized approach." @default.
• W2097777237 created "2016-06-24" @default.
• W2097777237 creator A5009577142 @default.
• W2097777237 creator A5035036080 @default.
• W2097777237 date "1999-02-01" @default.
• W2097777237 modified "2023-10-16" @default.
• W2097777237 title "VALVULAR DISEASE IN THE ELDERLY" @default.
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