Heart Diseases in Geriatric Patients in Imaging in Geriatrics

Increased longevity will result in increasing numbers of elderly patients worldwide, among whom heart disease is the most common cause of death. Ageing is the most important risk factor for the development of cardiovascular diseases due to progressive changes in cardiac metabolism, function and structure and for vascular age-related changes. Moreover, cardiovascular comorbidities increase with increasing age, further affecting cardiovascular function and physiology. In the recent years improvement in treatments, also with the development and spread of percutaneous interventions, increased the chance of treatments of even fragile patients. Advanced cardiac imaging plays a crucial role in clinical decisions-making, guidance to treatment and prognostication, providing a comprehensive non-invasive characterization of myocardium and coronary arteries, from morphofunctionality to structural alteration. Currently, no available guidelines provide clear indications on the type and operating modalities of the various imaging techniques available for cardiac imaging in the elderly population. This chapter attempts to summarize the role of advanced cardiac imaging modalities (computed tomography and magnetic resonance) in the setting of most frequent cardiac disease occurring in elderly patients, especially coronary artery disease, valve disease and heart failure.