Clinical Profile of Acute Myocardial Infarction in elderly

Abstract

Background: The clinical picture of Myocardial Infarction (MI) in elderly patients differs in many aspects as compared to younger/middle age patients. Hence the present study was undertaken to know and compare risk factors, clinical features, complication and outcome of middle age (35-60yr) to elderly (>60yr) patients with acute myocardial infarction (AMI).

Methods: This study enrolled total 100 cases of AMI of which 50 cases belonged to group I (age 35-60yr) and 50 cases belonged to group II (age >60 years). AMI was diagnosed using World health organization (WHO) MONICA criteria. Patients were analyzed on the basis of risk factors, clinical presentation, complication and outcome.

Results: Male to female ratio was 2.8:1 in group I and 1.7:1 in group II indicating occurrence of MI was common in elderly male. The elderly (>60yrs) were more likely to have atypical presentations (44%) while middle age patients have Typical chest pain, (62%). Dyspnoea was common in elderly person (56%). Hypertension, Dyslipidemias, Diabetes mellitus, smoking, alcohol addiction, obesity and family history of coronary artery disease were the observed risk factors in group I (35-60yrs), more in males. Anterior wall MI (36 patients) was commonest followed by inferior wall MI (23 patients) and anteroseptal wall MI (20 patients). The complications like cardiac failure, arrhythmias, cardiogenic shock, re-infarction were commonly seen in group II (>60y) during hospital stay. Mortality was higher in >60 year patients (32%), especially in males (62.5%).

Conclusion: The manifestations of AMI are more subtle in the elderly, with different risk factors. The elderly subjects are under thrombolysed and have higher complication and mortality rate.