title: Management of myocardial infarction in the very elderly--impact of clinical effectiveness on practice.
abstract: The presentation of myocardial infarction in the elderly is often atypical and there is therefore a broad range of clinical presentations where this diagnosis should be actively considered and the appropriate investigations arranged. The early use of aspirin and thrombolytic therapy has revolutionised management and efforts should be made to employ these interventions wherever possible. We present the results of an audit showing how the introduction of local guidelines improved the early management of myocardial infarction in the elderly. We also found that in this group of patients cardiac enzyme assays were more useful in establishing the diagnosis than the electrocardiogram.
authors.affiliation: Department of Medicine for the Elderly, Grampian University Hospitals NHS Trust.
authors.forename: A M
authors.initials: AM
authors.lastname: Qureshi
authors.forename: L
authors.initials: L
authors.lastname: McDonald
authors.forename: W R
authors.initials: WR
authors.lastname: Primrose
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D004562:Electrocardiography; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D015912:Thrombolytic Therapy
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin