The geriatric cardiologist come to see cardiovascular system within a perspective of an aging body that is likely to be frail, noncompliant, disorganized, and confused, experiencing impaired function of several organ systems (particularly the kidney), and damage from earlier diseases. Poor lifestyle-choices, inadequate preventative health habits, consuming a great variety of frequently prescribed medications, and in a situation where the parsimony of science (Occams Razor) no longer applies, but rather the development of geriatric cardiology was coincident with improving survival among the so-called post-retirement elderly after 1970.
The prevalence of systolic and diastolic heart failure, atrial fibrillation, aortic stenosis, and electrical conduction defects increases with age, resulting in a significant burden of cardiovascular disease. To address the needs of a growing geriatric population, future cardiologists require education specifically directed at appropriate evaluation and risk stratification of elderly patients. Incorporating comprehensive geriatric assessments, aging pharmacokinetics, and frailty into the core curriculum will arm fellows with the ability to interpret guideline phrases such as “in select individuals” and “careful risk benefit analysis” as they relate to older patients.