Document Detail

Age-related pulmonary crackles (rales) in asymptomatic cardiovascular patients.
MedLine Citation:
PMID:  18474887     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The presence of age-related pulmonary crackles (rales) might interfere with a physician's clinical management of patients with suspected heart failure. We examined the characteristics of pulmonary crackles among patients with stage A cardiovascular disease (American College of Cardiology/American Heart Association heart failure staging criteria), stratiffed by decade, because little is known about these issues in such patients at high risk for congestive heart failure who have no structural heart disease or acute heart failure symptoms. METHODS: After exclusion of comorbid pulmonary and other critical diseases, 274 participants, in whom the heart was structurally (based on Doppler echocardiography) 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 prevalence of crackles among patients in the low (45-64 years; n = 97; 11%; 95% CI, 5%-18%), medium (65-79 years; n = 121; 34%; 95% CI, 27%-40%), and high (80-95 years; n = 56; 70%; 95% CI, 58%-82%) age-groups (P <.001). The risk for audible crackles increased approximately threefold every 10 years after 45 years of age. During a mean follow-up of 11 +/- 2.3 months (n = 255), the short-term (< or =3 months) reproducibility of crackles was 87%. The occurrence of cardiopulmonary disease during follow-up included cardiovascular disease in 5 patients and pulmonary disease in 6. CONCLUSIONS: Recognition of age-related pulmonary crackles (rales) is important because such clinically unimportant crackles are so common among elderly patients that, without knowledge of this phenomenon, their existence might interfere with the physician's management of cardiopulmonary patients.
Hajime Kataoka; Osamu Matsuno
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of family medicine     Volume:  6     ISSN:  1544-1717     ISO Abbreviation:  Ann Fam Med     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-05-13     Completed Date:  2008-06-24     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  101167762     Medline TA:  Ann Fam Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  239-45     Citation Subset:  IM    
Division of Internal Medicine, Nishida Hospital, Oita, Japan.
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MeSH Terms
Age Factors
Aged, 80 and over
Cardiovascular Diseases / diagnosis*
Lung Diseases / diagnosis*
Middle Aged
Prospective Studies
Respiratory Sounds / diagnosis*
Risk Factors

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