Clinical presentation, risk factors, complications and outcome of acute myocardial infarction in elderly patients

Sandhya S.; Mohanraj P.

doi:10.18203/2320-6012.ijrms20174669

Authors

Sandhya S. Department of Medicine, Meenakshi Medical College Hospital and Research Institute, Kanchipuram, Tamil Nadu, India
Mohanraj P. Department of Medicine, Meenakshi Medical College Hospital and Research Institute, Kanchipuram, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20174669

Keywords:

Acute myocardial infarction, Chest pain, Coronary heart disease, Elderly

Abstract

Background: Myocardial Infarction is one of the most common causes of mortality and morbidity among the elderly patients. Also, it is known for wide range of clinical presentations other than chest pain. This article enlightens the clinical features, risk factors, complications, prognosis and outcome of Acute myocardial infarction in elderly patients. The objective of this study was to assess the risk factors, various symptoms, complications, prognosis and outcome of elderly patients with Acute myocardial Infarction (AMI).

Methods: This is a prospective study done over a period of two years in a tertiary care hospital in South India. 80 elderly patients who were diagnosed as AMI were included in the study.

Results: Among the eighty patients the majority of the patients belonged to the age group 60-69 years. Twenty percent of the patients presented without chest pain. The atypical presentations included dyspnoea, giddiness, vomiting, sweating and epigastric pain. Mortality rate was 20%.

Conclusions: This study showed that even though chest pain was the most common presentation in elderly AMI patients, they were also found to have atypical presentations like shortness of breath, giddiness, vomiting, sweating and epigastric pain. This signifies the need of examining physicians to meticulously identify acute myocardial infarction in elderly though they may not present typically.

Metrics

Metrics Loading ...

References

Cardiovascular disease in elderly. In:Libby PP, Bonow RO, Mann DL, Zipes DP. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 8th edition. Philadelphia: Elsevier Science, 2007.

Ochiai Marcelo E., Lopes Neusa Helena, Buzo Carolina Giusti, Pierri Humberto. Atypical Manifestation of Myocardial Ischemia in the Elderly. Arq. Bras. Cardiol. [Internet]. 2014; 102( 3 ): 31-33.

Milner KA, Vaccarino V, Arnold AL, et al. Gender and age differences in chief complaints of acute myocardial infarction (Worcester Heart Attack Study). Am J Cardiol2004;93:606-608.

Avezum A, Makdisse M, Spencer F, et al. Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE). Am Heart J2005;149:67-73.

Eagle KA, Goodman SG, Avezum A, et al. Practice variation and missed opportunities for reperfusion in ST-segment-elevation myocardial infarction: findings from the Global Registry of Acute Coronary Events (GRACE). Lancet 2002; Vol – 359, Issue - 9304:373–377.[PMID: 11844506].

Alexander K, Roe MT, Kulkarni SP, et al. Evolution of cardiovascular care for elderly patients with non-ST-segment elevation acute coronary syndromes: Results from CRUSADE. J Am Coll Cardiol 2005;46:I490-I495.

Mikkola TS, Gissler M, Merikukka M, Tuomikoski P, Ylikorkala O. Sex differences in age-related cardiovascular mortality. PLoS One. 2013;8(5):e63347.

Vaccarino V, Rathore S, Wenger N, et al: National Registry of Myocardial Infarction Investigators: Sex and racial differences in the management of acute myocardial infarction, 1994 through 2002. N Engl J Med 2005; 353:671-682(B1)

Bhatia LC, Naik RH. Clinical profile of acute myocardial infarction in elderly patients. J Cardiovasc Dis Res. 2013;4:107–111.

Goldberg RJ, Yarzebski J, Lessard D, Gore JM. Decade-Long Trends and Factors Associated With Time to Hospital Presentation in Patients With Acute Myocardial Infarction - The Worcester Heart Attack Study. Arch Intern Med. 2000;160(21):3217–3223.

Avezum A, Makdisse M, Spencer F, et al. Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE) Am Heart J. 2005;149:67–73.

Saczynski JS, Yarzebski J, Lessard D, Spencer FA, Gurwitz JH, Gore JM, Goldberg RJ. Trends in Prehospital Delay in Patients With Acute Myocardial Infarction (from the Worcester Heart Attack Study) Am J Cardiol. 2008;102:1589–1594.

R.H. Mehta, S.S. Rathore, M.J. Radford, Y. Wang, H.M. KrumholzAcute myocardial infarction in the elderly: differences by ageJ Am Coll Cardiol, 38 (2001), pp. 736-741

Ornato JP, Peberdy MA, Tadler SC, Strobos NC. Factors associated with the occurrence of cardiac arrest during hospitalization for acute myocardial infarction in the second National Registry of Myocardial Infarction in the US. Resuscitation. 2001;48:117–123.

Thompson CR, Buller CE, Sleeper LA, Antonelli TA, Webb JG, Jaber WA, et al. Cardiogenic shock due to acute severe mitral regurgitation complicating acute myocardial infarction: A report from the SHOCK Trial Registry - Should we use emergently revascularize occluded coronaries in cardiogenic shock? J Am Coll Cardiol. 2000;36:1104–9.

Menon V, Webb J. G, Hillis L. D et al. Outcome and profile of ventricular septal rupture with cardiogenic shock after myocardial infarction: a report from the shock trial registry. should we emergently revascularize occluded coronaries in cardiogenic shock? Journal of the American College of Cardiology. 2000;36:1110–1116.

Limacher M. Clinical features of coronary heart disease in the elderly. Cardiovasc Clin 1 992;22(2):63-73