Trauma in patients with pre-existing cardiac disease.

More than 30% of trauma patients over 55 years of age have pre-existing diseases and by the time these patients reach 65 years of age, 13.7% of them will have hypertension, 9.2% will have chronic obstructive pulmonary disease (COPD), 6.3% will have diabetes, and 5.6% will have coronary artery disease (CAD). By the age of 75 years, 12.9% will have CAD, and the most frequent cause of death in elderly individuals living for more than 48 hours after trauma will be sepsis and/or CAD. To obtain the best results in patients with pre-existing cardiac disease, one must have a high suspicion of its presence and aggressively treat the patient to prevent hypotension and hypoxemia. Early monitoring and optimization of cardiac output, organ delivery, and oxygen consumption are particularly important in elderly trauma patients if they require general anesthesia or ICU care.