Natural history of angina pectoris in the aged. Clinical, pathologic, surgical, and epidemiologic correlations

In the present state of our knowledge of the advantages and hazards of coronary artery bypass surgery in the aged and of our lack of knowledge as to its effects on the progression of coronary atherosclerosis and life expectancy, only certain individuals over 75 yr of age should have diagnostic evaluation for consideration of bypass surgery. Such individuals should have disabling intractable angina and be in a sufficiently good state of physical and mental health so that one would expect a sufficiently beneficial effect on their symptomatology, ventricular function, exercise tolerance, and the rate of occurrence of subsequent acute myocardial infarctions, to justify the possible adverse effects of invasive diagnostic procedures and surgery on morbidity, mortality rates, function and life expectancy.