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The use and interpretation of noninvasive cardiac testing in the elderly may differ from that in younger patients due to changes in disease prevalence, normal values, comorbidities, or patient and physician preferences. This paper reviews the experience with several commonly used noninvasive tests such as electrocardiography, exercise testing, and stress imaging with echocardiography or with scintigraphy in geriatric patients. Most commonly used noninvasive tests remain feasible and safe. Data suggest that exercise stress testing is feasible in many elderly patients with a good safety profile and should be considered as a first-line test due to the extra information provided by the duration and hemodynamic response to exercise. Adjunctive imaging may be particularly helpful when the electrocardiogram is uninterpretable or suspect due to underlying baseline abnormalities or when determining the extent or distribution of ischemia is felt to be important.

Hypertrophic cardiomyopathy is a familial cardiac disease with exceptionally diverse clinical and morphologic presentations. The influence of age on the disease manifestation has become increasingly clear over the last decade. Most initial reports concentrated on characterization and treatment of the disease in younger individuals, but a better appreciation of hypertrophic cardiomyopathy in elderly patients has yielded important information regarding clinical presentation, morphologic appearance on echocardiography, prognosis, and management. This paper reviews the literature focusing on the age-related differences in hypertrophic cardiomyopathy.