PURPOSE: This study examined characteristics of pulmonary crackles among the cardiovascular patients in stage A status (ACC/AHA chronic heart failure guidelines) because little is known about these issues in asymptomatic cardiovascular patients accmpanying heart failure risk factors.
METHODS: After exclusion of co-morbid pulmonary and other critical disease(s), 274 participants, in whom the heart was structurally (based on echo/Doppler evaluation) and functionally (B-type natriuretic peptide<80 pg/ml) normal, and the lung (X-ray evaluation) was normal, were eligible for the analysis.
RESULTS: There was a significant difference in the incidence of crackles among patients in the low (45–64 year; n = 97; 11%; 95% confidence interval [CI] 5–18%), medium (65–79 year; n = 121; 35%; 95% CI 26–43%), and high (80–95 year; n = 56; 70%; 95% CI 58–82%) age groups (p's<0.001). Aging was associated with the extension of crackles from the unilateral to the bilateral hemithorax. The risk for audible pulmonary crackles increased approximately 3-fold every 10 years after 45 years old. During a mean follow-up of 11 ± 2.3 months (n = 255), the short-term (≤;3 months) reproducibility of crackles was 87%. The occurrence of cardiopulmonary disease over the entire follow-up included critical cardiovascular disease in 5 patients and pulmonary disease in 6.
CONCLUSION: Localized basal crackles are common in elderly patients with stage A cardiovascular status. The presence of such age-related crackles is less clinically important, and should not be mistakenly diagnosed as a sign of heart failure.
CLINICAL IMPLICATIONS: Recognition of these age-related crackles is important because such crackles are so common among near-normal elderly cardiovascular patients that, without knowledge of this phenomenon, their existence might interfere with the physician's management of the patients.
DISCLOSURE: Hajime Kataoka, No Financial Disclosure Information; No Product/Research Disclosure Information