Acute MI. Age-related presentations and treatment options.
At least 60% of all acute myocardial infarctions (AMIs) occur in patients age 65 and older and about one-third in patients older than age 75. The presentation of AMI is modified by age-related changes in endothelial function, smooth muscle cell activity, diastolic function, and responses to circulating catecholamines. Atypical presentations are common in the older patient and require the physician to maintain a high index of suspicion for AMI. ECG findings of ST-segment depression make many older patients ineligible for reperfusion by thrombolytic therapy. Acute and post-MI medical therapies are underused in the older population and should be individualized, based on the presence of comorbid conditions.
Maheshwari
A
A
Department of Internal Medicine, Saginaw Cooperative Hospitals, Inc., MI, USA.
Laird-Fick
H S
HS
Cannon
L A
LA
DeHart
D J
DJ
D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D002395:Catecholamines / Q000097:blood; D002985:Clinical Protocols; D000075202:Contraindications; D003971:Diastole; D004562:Electrocardiography; D004730:Endothelium, Vascular / Q000503:physiopathology; D006801:Humans; D009131:Muscle, Smooth, Vascular / Q000503:physiopathology; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D010347:Patient Care Planning; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015912:Thrombolytic Therapy
D000925:Anticoagulants; D002395:Catecholamines; D010975:Platelet Aggregation Inhibitors