Management of heart disease in the elderly in the Plymouth Health District.

In the light of a report from the Royal College of Physicians, the management of heart disease in the elderly (> 70 years) was studied in the Plymouth Health District in 1992. A survey of general practitioners was undertaken to assess how they would handle particular aspects of heart disease in their elderly patients. The admissions of older patients to the coronary care unit following an acute myocardial infarction and their outcome were detailed. The numbers of non-invasive cardiological investigations undertaken in the elderly were monitored, as were the referral rates to a cardiology outpatient clinic. The overall conclusion is that physicians and general practitioners alike view coronary artery disease as a medical condition with little consideration of the surgical option, despite good evidence that elderly patients often do very well following coronary artery bypass grafting. Future resource planning should address the problem of an overburdened cardiac surgery service.