With age comes wisdom, and also cardiac complications. As a person grows old, the heart, too, ages, which can affect its functioning. Experts highlight that the aging of other organs also affects heart health. If people over the age of 65 frequently observe issues such as severe shortness of breath, chest pain or lightheadedness, it could be a symptom of heart disease. Moreover, one of the most common heart problems in the elderly is a low heart rate, which could lead to heart failure.
How does your heart change with age?
Dr Sunil Dwivedi, consultant, cardiology, Manipal Hospital Millers Road, Bengaluru, explains, “The heart is not isolated. The nervous system, heart and blood vessels all age. Over the years, the heart muscles stiffen and don’t relax well, affecting the pumping capacity of the organ, leading to heart failure.”
Experts say in a healthy population with no family history of heart disease, age-related complications can take a toll on heart health after the age of 65 years. Dr Abhijit Vilas Kulkarni, senior interventional cardiologist, Apollo Hospitals, Bengaluru, adds the most common and unmodifiable risk factor for heart disease is age. “Age-related heart problems can broadly be classified into three categories. This includes issues with the heart’s conduction system, its pumping capacity and valve-related problems,” he informs.
How do doctors diagnose heart disease?
It can be challenging to diagnose the right heart disease in older adults as the cardinal symptoms are the same. They include breathlessness, angina or chest pain, syncope (loss of consciousness), dizziness and edema (swelling of the feet). “Any problem connected with the heart generally manifests as one of these symptoms. So, it’s crucial to perform a basic evaluation in the form of electrocardiogram (ECG) and echocardiogram. With this, we can understand the problem and identify the part of the heart affected so that certain emergencies can be prevented,” he adds.
What are the common heart problems in the elderly?
1. Bradycardia
One of the most common age-related conditions is low heart rate or bradycardia. This happens when there is no proper coordination between the heart muscles and the body’s electrical impulses, affecting the pumping. Dr Kulkarni says that is why people feel fatigue and giddiness or experience syncope. “Sometimes, older people can fall unconscious and then get up, all confused. This happens because the heart rates are extremely low during that time,” he adds.
2. Atrial fibrillation
As one ages, the cardiac conduction system can also get affected. Dr Dwivedi shares that as the heart’s electrical system starts degenerating, the heart rate can either slow down or speed up. One of the commonest rhythm issues is atrial fibrillation, an irregularity of the rhythm of the upper chambers of the heart. It can lead to heart failure and stroke.
Atrial fibrillation causes a lot of small clots in the heart. Due to the altered heart rate, one can briefly have low heart output or low blood flow, leading to loss of consciousness or transient ischemic attack (TIA).
3. Transient ischemic attacks
When the blood supply to the brain is briefly interrupted, one can have TIA. Dr Dwivedi explains, “The interruption can be because of cholesterol blocks in the blood supply to the brain. It has the same mechanism as a heart attack.”
4. Leaky heart valve
One of the other common problems in the elderly is the degeneration of the heart valves, making them narrow and leaky. Experts say the aortic and mitral valves are the most affected due to calcification. These conditions are called aortic valve stenosis and mitral valve regurgitation or leaky heart valve, respectively. Once calcium is deposited, it significantly affects the normal functioning of the valves, making them difficult to open while the heart contracts, explains Dr Kulkarni.
5. Coronary artery disease
Due to aging, cholesterol and calcium deposition occur, which affects the blood supply, mentions Dr Dwivedi. Coronary artery disease is caused by the buildup of cholesterol in the arteries which leads to the narrowing of the arteries that supply blood to the heart. It can sometimes have no symptoms, while at other times, it can lead to chest pain or heart attack.
The elasticity of blood vessels that supply blood to our body also gets reduced. It stiffens, leading to a rise in systolic blood pressure, more than diastolic blood pressure.
6. Broken Heart Syndrome
Dr Dwivedi highlights that broken heart syndrome is caused due to emotional stress. “It can happen in older people when they lose their spouse. Depression can also cause cardiac issues, such as heart failure or rhythm disturbances or heart attack, he adds.
7. Heart failure
Aging causes stiffening of the heart muscle. As a result, the heart may be able to pump well but be unable to relax properly. It may not be able to accumulate the blood from other parts of the body due to cardiac fibrosis “This leads to swelling in the body, causing heart failure with preserved ejection fraction,” explains Dr Dwivedi.
All the other heart conditions can also lead to severe complications like heart failure.
Precautions for heart problems in elderly
Dr Dwivedi shares, “As you grow old, you tend to put on more weight because the body is designed to reduce the metabolic rate every five years. So, the exercises and diet or calorie intake that are relevant for you now will not be relevant at that point — they will need to be modified every fifth year.”
He also adds a healthy lifestyle is the key and it should be started early in life. The sooner you pick up healthy lifestyle habits, the more benefits you reap. Experts suggest the following measures to delay age-related heart issues:
- Managing risk factors like cholesterol, BP and diabetes
- Ensuring routine checkups
- Maintaining an active lifestyle
- Reducing stress
- Exercising regularly
- Avoiding smoking and alcohol intake
- Sleeping properly
