Significance of atypical symptoms for the diagnosis and management of myocardial infarction in elderly patients admitted to emergency departments

Abstract

Atypical clinical symptoms of STEMI are common and severe among elderly patients in EDs. Thus, rapid provision of an electrocardiogram to all elderly patients admitted to the ED is essential, even in the absence of cardiovascular symptoms.

Hospital outcomes of older people with cognitive impairment: An integrative review

“…Contradictory findings regarding the contribution of dementia to mortality in patients presenting to hospital with acute myocardial infarction (AMI) could relate to variation in care provision, as patients with dementia report less chest pain and wait longer for treatment, have fewer transfers to intensive or coronary care units, and less frequent provision of invasive interventions . Dementia was not found to be associated with hospital mortality in patients with stroke, or those with an ICU admission …”

Gender and Age Differences Associated With Prehospital Delay in Chinese Patients Presenting With ST-Elevation Myocardial Infarction

“…As an important risk factor for longer prehospital delays, atypical clinical symptoms of STEMI are very common and often severe among elderly patients. 27,28 Atypical clinical symptoms can prevent early recognition of a cardiac problem, resulting in a delay in seeking medical care. 19 Although medical history and risk factors including hypertension, diabetes, and so on, are associated with extent of prehospital delay in patients with STEMI, 7,8,21 these reasons for delay were not the key factors among different age and gender groups.…”

Impact of delirium on patients hospitalized for myocardial infarction: A propensity score analysis of the National Inpatient Sample

“…Previous reports showed variable rates of up to 5%. This is likely because studies have utilized different inclusion criteria and assessment methods . Our study excluded patients who received mechanical ventilation or CABG, as both are known to be associated with delirium.…”

“…In patients with myocardial infarction (MI), delirium that occurred in up to 5.7% of patients was reported, often as an atypical presentation of myocardial infarction . When limited to elderly patients ≥75 years of age, the prevalence is even higher . Therefore, the burden of delirium will increase over time as the population ages.…”