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lecture24-Aging Heart Navazio

lecture24-Aging Heart Navazio - Aging of Cardiac Muscle and...

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Aging of Cardiac Muscle and Cardiac Failure Dr. Franco Navazio
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Aging Heart in the Elderly In absence of specific disease the heart adjusts very well to advancing age.
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Myocardium : Cardiac muscle syncytium (multi-nucleated) Endocardium : Internal layer of heart Pericardium : External connective tissue layer of heart Valves : openings between cardiac chambers (atrial ventricular) or between heart the arteries (aorta and pulmonary) Conduction system : sinoatrial node (SA) is the pacemaker; also atrial ventricular node (AV), Bundle of His, Purkinje system
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Aging Heart: Physiology Decline in the VO 2 Max with advancing age Minor decline in the cardiac output Important Variables: physical conditions dietary habits Conclusions: Physically fit elderly people have a cardiac physiology similar to younger individuals
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Physiological Changes with Age Parameter 20 years 60 years VO 2 Max (mL x kg x min) 39 29 Maximum Heart Rate 194 162 Resting Heart Rate 63 62 Max. Cardiac Output (L x min) 22 16 EJECTION FRACTION 70-80% 50-55% Resting BP 120/80 130/80 Total Lung Capacity (L) 6.7 6.5 Vital Capacity (L) 5.1 4.4 Residual Lung Volume (L) 1.5 2.0 Body Fat % 20.1 22.3
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Cardiovascular Changes with Age Hypertension: most common treatable cardiovascular change in the elderly Definition: values above 140/90 In young, if standing BPincreases slightly but in elderly it may drop up to 20 mmHg Systolic mumur : 50% of elderly but of very short duration EKG (or ECG): only nonspecific changes due to aging in voltage and nonspecific RBBB Hypotension : diminished baro-reflex response in the elderly. With age, cerebral blood flow but autoregulation acts in a compensatory fashion; some patients maybe affected by symptomatic orthostatic hypotension Orthostatic hypotension : drop of 20 mmHg in the systolic and 10 or more in the diastolic BP on standing upright *MEMO as well as the post-prandial hypotension
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Pathology of the Aging Heart Changes due to: Normal Aging Processes Superimposed Processes (i.e. endocarditis) Residuals of other conditions (i.e. hypertension, bicuspid, aortic valve
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Aging Heart Size : can atrophy
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