MODULE SUPPLEMENT: CARDIOVASCULAR SYSTEM
Case 3: Points To Consider

1. We know that older adults are often predisposed to orthostatic hypotension because baroreceptors are less responsive and heart rate can't increase quickly to increase cardiac output.

2. Mr. Wong is on two medications that influence blood pressure and older adults are more sensitive to their anti-hypertensive effects.

3. Chlorthalidone decreases fluid volume. The older heart, which is stiffer and fills more slowly, is dependent on adequate filling to maintain cardiac output (via the Frank Starling Mechanism). Thus dehydration can predispose to cardiac dysfunction.

4. Changes in the cardiac conduction system predisposes older adults to arrhythmias.

5. In addition to age related changes, Mr. Wong has a number of clinical conditions that put him at risk and although we are focusing on the cardiovascular system, it's important to consider the neurologic changes that might also be involved.