Clinical manifestations, diagnostic assessment, and etiology of heart failure in elderly patients.

Heart failure in elderly patients may be difficult to diagnose because of a lack of typical symptoms and physical findings that are common in younger patients with this disorder. When present, the symptoms and signs are often nonspecific and mistakenly may be thought to be caused by other disorders that are commonly present in elderly patients. In older elderly patients, the symptoms and signs may be obscured by the presence of aging changes or other diseases. As a result of these problems, physicians must be highly suspicious of heart failure in all elderly patients who have underlying heart disease or who present with nonspecific symptoms that may represent heart failure. After the diagnosis of heart failure is established, the cause must be determined and systolic and diastolic ventricular dysfunction must be differentiated.