Anand Premanand Ambali, Jairaj Vijaykumar Bomman
BACKGROUND The longevity has increased in India and is further going to rise. The elderly are living with medical, social and psychological problems. Acute myocardial infarction in elderly often presents with atypical presentation and hence leads to delay in diagno sis and increased mortali ty. The presence of multiple co morbidities adds to increased morbidity and low quality of life. Acute myocardial infarction is leading cause of death in elderly in India. MATERIALS AND METHODS This study did a prospective analysis of 150 elderly patients (>60 years) irrespective of sex, admitted in cardiac care unit and diagnosed having first episode of acute myocardial infarction. The associated comorbidities, type of myocardial infarction, biochemical levels and outcome is studied over a period of two years. RESULTS The study grou p had 150 elderly participants among whom males were 60% and 75% were in young old (60 74 years) age group. Atypical presentation was seen in 29% of participants and hyperlipidaemia was commonest comorbid condition noted among 73%. The biochemical marker Troponin T was not very effective in making diagnosis of Acute Myocardial Infarction in elderly. Anterior wall myocardial infarction was common in 37% while complication was noted in 17% of the study participants. The overall mortality rate was 6%. CONCLUSION A cute myocardial infarction leads to increased morbidity in elderly. The atypical presentation leads to delay in diagnosis whi le presence of multiple comorbidities leads to poor outcome, both of which pose challenges for the clinicians. The presence of hyperlipidaemia as comorbidity is emerging in elderly too. Arrhythmias as complication leads to increase in mortality. The holistic approach is need of hour to manage the person wi th multiple comorbidities.
