More patients now live beyond 100 — and most of our guidelines stop at 75 or 80. In this masterclass we cover cardiac care for centenarians and the very old: the physiology of the ageing heart (arterial stiffness, diastolic dysfunction, conduction disease, blunted reserve) and the high prevalence of wild-type ATTR amyloid; comprehensive geriatric assessment, the Clinical Frailty Scale and goals of care; avoiding both ageism and over-treatment; deprescribing with STOPP/START and Beers criteria and dosing by Cockcroft-Gault; individualised blood pressure targets and orthostatic hypotension (HYVET, SPRINT); anticoagulation for atrial fibrillation with appropriately dosed DOACs, falls, and very-low-dose edoxaban (ELDERCARE-AF); HFpEF and gentle diuresis, SGLT2 inhibitors (EMPEROR-Preserved, DELIVER); TAVR in nonagenarians and centenarians and the risk of futile procedures; mitral and tricuspid TEER (COAPT, TRILUMINATE); acute coronary syndromes in the very old (After Eighty, SENIOR, MOSCA-FRAIL, POPular AGE), clopidogrel and short DAPT; bradyarrhythmias, leadless pacing, syncope and falls; why ICDs are rarely appropriate and the evidence gap for statins (STAREE, PREVENTABLE); dementia and capacity, CKD and anaemia; the hazards of hospitalisation and delirium; family caregiving in India; lifestyle at 100; and advance care planning — illustrated with a 101-year-old patient's case.

Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D., Senior Interventional Cardiologist, author, educator and founder of the Academy of Elite Doctors.
Host: Alexander Wood

Cardiology Course FM is the station for doctors, students, nurses and everyone who looks after the heart.

Learn more:
• Cardiology books: https://cardiologybooks.com
• Mentorship with the Academy of Elite Doctors: https://academyofelitedoctors.com
• Online cardiology courses: https://cardiologycourse.com
• World Elite Doctors: https://worldelitedoctors.com

For medical education only. This episode is not a substitute for individual medical advice.