The aging electrocardiogram

Abstract

With advancing age, widespread histologic changes in the conduction system occur. These changes may alter several features of the aging electrocardiogram, including duration of the PR and QT intervals, orientation of the electrical axis, duration and morphology of the atrial and ventricular complexes, and characteristics of the ventricular repolarization. And although ST segment and T wave abnormalities may be the only clue to acute ischemia, they are nonspecific and associated with a multitude of noncardiac causes. With an awareness of atypical presentations and difficulties in ECG interpretation, emergency physicians may be able to improve the assessment and triage of elderly patients with acute coronary ischemia.