Congestive heart failure in the elderly. The therapeutic challenge of atypical presentations.

Congestive heart failure (CHF) is a common cause of morbidity and mortality in the elderly. Symptoms and signs of CHF in the elderly often differ from those in younger patients. Careful attention to these subtle differences helps in detection of concomitant illnesses that mimic or mask heart failure. The therapeutic approach to CHF in elderly patients is similar to that in younger patients. However, in the elderly, increased attention should be paid to the side effects and interactions of the drugs commonly prescribed. Diastolic dysfunction is a recently recognized factor in the pathogenesis of CHF. Because diastolic dysfunction is treated differently than systolic dysfunction, evaluation of CHF should include a search for both entities.