ISSN 0975-3583

Journal of Cardiovascular Disease Research

    Acute myocardial infarction in the elderly: Differences in clinical presentation from younger patients

    Dr. Durga Prasad Sadhupati, Dr. Vijaya Krishna Maanam
    JCDR. 2023: 74-83


    In particular for elderly patients, cardiovascular disease is the main cause of morbidity and mortality. It is generally accepted that elderly people exhibit unusual acute MI symptoms. There are fewer local studies on the prevalence of atypical acute myocardial infarction presentation in the elderly than in the younger population. Study the clinical manifestation, risk factors, complications, management, and hospital outcome of AMI patients aged >60 years (elderly), and compare the variations with those aged less than 60 years (younger). Methods: 50 patients >60 years old (Group 1-elderly) who presented with AMI between February 2021 to October 2021 at Department of General Medicine, Siddartha Medical College, Vijaywada, Andhra Pradesh, India, were examined as part of this prospective observational cross-sectional study to determine their clinical characteristics, complications, management, and mortality. Differences between 50 patients with AMI who were under the age of 60 (Group 2-younger) in terms of clinical presentation. Results: Group 1 had a 1.63:1 male to female ratio, while Group 2 had a 4.5:1 ratio. Patients in the elderly group reported experiencing 48% atypical chest pain and 24% had no chest pain at all, as opposed to 20% and 4%, respectively, in the younger group. Breathlessness, syncope, giddiness, altered sensorium, and abdominal pain were also more common in elderly patients (52% vs 18%; p=0.001). In comparison to patients who arrived earlier, 72% of elderly patients arrived at the hospital within 12 hours, while only 42% of elderly patients did so (p 0.05). The elderly group utilized beta blockers (46% of them) and thrombolytic therapy (56%) less than the younger group (80% & 90%), respectively (P 0.05). HTN (44% vs 32%), and DM (30% vs 10%) from the past. Major complications like cardiac failure, cardiogenic shock, and arrhythmias were more prevalent in the elderly group (32%, 16%, and 32%) than in the younger groups (10%, 4%, and 10%) (P0.05). When compared to the younger group, older patients had significantly higher rates of mortality (26% vs 4% P0.05), as well as LV dysfunction (50% vs 22%). Patients who presented with cardiogenic shock, complete heart block, advanced age, patients without chest pain, and those who did not receive thrombolysis were linked to higher mortality in this study. Conclusion: The most frequent atypical symptom among elderly patients was breathlessness. These patients also underwent thrombolysis, had higher mortality, and experienced more complications than younger patients. In this study, mortality was higher in patients who had complete heart blocks, cardiogenic shock, were older, had no chest pain, or had not received thrombolysis. When an elderly patient presents abnormally, having knowledge of atypical presentation in elderly patients will help us to consider an acute cardiac event.


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    Volume 14 Issue 2