Do I need special Heart Tests at my age?

Submitted by Dr T on July 30, 2011 – 8:58am

Question:

Hi. I am an 80 year old male, in good health. Over the years my BP has stayed in the 120/80 range and my cholesterol readings have also been within range. I have no angina or other heart problem symptoms. I was born with a murmur, which usually is not noted during examinations. While I do have a urologist, dermatologist and allergist, I have not felt the need for a family physician, for many years. Since I just turned 80, I felt that it was time to see a doctor and start annual exams. The questionaire that the doctors office sent me was extensive and asked, amomg other questions, when I had my last ECG and stress tests. I would like to be prepared for my exam and any recommendations, for testing, that the doctor might have. Considering my age, as one factor and my being asymptomatic, as another, would you recommend any cardiac testing, if I was your patient? Thank you.

Not necessarily. At a healthy age 80, you have already passed many of the hurdles of most of your contemporaries. If you came to my office, you would get a routine physical & history exam, during which I’d try to find anything specific to focus on. Most of this would become clear from your answer in the questionnaire.

These are some recommendations that your doctor will probably chose from:

MEN OVER 65 YEARS OLD:

Every Year

Height/weight measurements
Blood pressure check
Physical exam for cancers (skin, thyroid, lymph nodes, prostate and rectum)
Stool sample check for blood
Dental exam

Every 1-3 Years

Thyroid hormone check
Blood count
Cholesterol check
Blood sugar check
PSA (prostate-specific antigen)
Hearing check
Vision and Glaucoma check
Lab tests or urine sample

Every 3-5 Years

Sigmoidoscopy for colon cancer

As an adult you should have the following shots:

Influenza every year
Tetanus booster at least every 10 years for lockjaw
Pneumococcal pneumonia vaccine at age 65

Next, I’d recommend some routine blood tests, based on these recommendations (choosing from tests like Thyroid stimulating hormone (TSH), Fasting blood glucose, Cholesterol, PSA (prostate-specific antigen), a Chest X-ray, EKG and urinalysis. Some other screenings include routine tests such as a colonoscopy for people over the age of 50. Men should have annual prostate exams beginning at age 45.

Since you ask me this question and I am a (retired) cardiac surgeon, I’d suggest you answer this questionnaire to calculate your risk for heart disease and/or stroke (low, I suspect):
https://www.cardiachealth.org/app/risk-assessment.php

There should be no need for a stress test in the absence of any symptoms, but a cardiac ECHO might be useful to check that murmur. Older (even very healthy) patients may develop a condition called aortic stenosis and an ECHO of your heart will rule that out once and for all.

Your doctor should also discuss healthy life style routines with you, most of which I assume you already follow, focusing on diet and exercise:

https://www.cardiachealth.org/heart-disease-treatment/diet-exercise-dis
https://www.cardiachealth.org/patients/diet/mediterranean-diet

Hope this helps,
Dr T
https://www.cardiachealth.org/

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