Life expectancy for men and women has increased and the proportion of elderly population is rising steadily. Concomitantly, the prevalence of cardiovascular disease has increased with aging and represents a leading cause of morbidity and mortality in older persons. The clinical manifestation and significance of various heart and vascular pathologies frequently differs from the younger age groups. Both cardiovascular disease and age-associated morphological and physiological changes of the cardiovascular system may significantly influence all aspects of perioperative evaluation and care in the elderly. The main challenge in preoperative evaluation is to differentiate the low-risk patient from the patients requiring further assessment or management because their risk is increased. Congestive cardiac failure, ischaemic heart disease, valvular disease and cardiac arrhythmias have the greatest impact on perioperative risk in the elderly.

        Key words: cardiovascular disease – perioperative risk – advanced age – cardiac failure – ischaemic heart disease