Stable ischemic heart disease in the older adults

Ischemic heart disease (IHD) is caused by atherosclerotic and/or thrombotic obstruction of coronary arteries. Clinical spectrum of IHD expands from asymptomatic atherosclerosis of coronary arteries to acute coronary syndromes (ACS) including unstable angina, acute myocardial infarction (non-ST elevation myocardial infarction and ST elevation myocardial infarction). Stable IHD (SIHD) refers to patients with known or suspected IHD who have no recent or acute changes in their symptomatic status, suggesting no active thrombotic process is underway. These patients include those with i) recent-onset or stable angina or ischemic equivalent symptoms, such as dyspnea or arm pain with exertion; ii) post-ACS stabilized after revascularization or medical therapy; and iii) asymptomatic IHD diagnosed by abnormal stress tests or imaging studies. This review summarizes clinical features and management of SIHD in the older adult. ACS in older adults is not considered in this review.