Background: Heart disease is leading cause of hospitalization and mortality in elderly patients. Presentation is atypical in these patients and risk factors pattern differs. The aim of this study was comparison of clinical profile , risk factors, complications, infarct type, management and outcome in patients 60 years or older (elderly) with acute ST elevation myocardial infarction compared with those younger than 60years (young) at a Government hospital in Gandhinagar.
Methods: This is a retrospective study of all new patients managed for acute ST elevation myocardial infarction in ICCU of GMERS Medical College and Hospital, Gandhinagar, Gujarat from January1, 2012 to December 31, 2013.
Results: Male to female ratio was 5:1 and 1.9:1 in young and elderly respectively. Most common clinical feature was chest pain i (98.6% in young vs.92.5% in elderly), with more atypical symptoms like breathlessness (15%) in elderly. Most young patients (56.7% vs. 32.5%) reached hospital within 6 hours of symptoms onset. In both groups most common areas of infarction were anterior (52.9% youngvs.50% old). Most common risk factors were (smoking (47.4%) in young vs. hypertension (51%) in elderly), Congestive cardiac failure was most common complication in elderly (64.5% vs.51.2%). Most young were thrombolysed (85.2% vs. 65%) as compared to old. High in hospital mortality in elderly (22.5% vs.11.5%) than young patients.
Conclusion: Acute ST elevation myocardial infarction is more subtle in the elderly, with high complications and mortality.
Elderly, acute ST elevation myocardial infarction, atypical Breathlessness