scholarly journals Clinical presentation, risk factors, complications and outcome of acute myocardial infarction in elderly patients

Author(s):  
Sandhya S. ◽  
Mohanraj P.

Background: Myocardial Infarction is one of the most common causes of mortality and morbidity among the elderly patients. Also, it is known for wide range of clinical presentations other than chest pain. This article enlightens the clinical features, risk factors, complications, prognosis and outcome of Acute myocardial infarction in elderly patients. The objective of this study was to assess the risk factors, various symptoms, complications, prognosis and outcome of elderly patients with Acute myocardial Infarction (AMI).  Methods: This is a prospective study done over a period of two years in a tertiary care hospital in South India. 80 elderly patients who were diagnosed as AMI were included in the study.Results: Among the eighty patients the majority of the patients belonged to the age group 60-69 years. Twenty percent of the patients presented without chest pain. The atypical presentations included dyspnoea, giddiness, vomiting, sweating and epigastric pain. Mortality rate was 20%.Conclusions: This study showed that even though chest pain was the most common presentation in elderly AMI patients, they were also found to have atypical presentations like shortness of breath, giddiness, vomiting, sweating and epigastric pain. This signifies the need of examining physicians to meticulously identify acute myocardial infarction in elderly though they may not present typically.  

Author(s):  
Rajesh Kumar Singhal ◽  
Harsha Kumar Gowardhan

Background: The cardiovascular diseases (CVDs) have become the leading cause of mortality worldwide. There is an increasing burden on health care systems associated with MIs in the elderly, differences in clinical picture, and difficulties in dealing with elderly patients with myocardial infraction (MI). Aim: The aim of study is to evaluate the different clinical presentations, risk factors and complications of elderly patients presenting with acute myocardial infarction. Methods: This is a retrospective, cross sectional study done over a period of 1 year. A total of 100 elderly patients who were diagnosed as AMI were included in the study. We studied Demographic features, cardiovascular risk factors, varied clinical presentations Electrocardiogram (ECG) findings from the history proformas and documented. Results: A total of 100 patients diagnosed with MI were studied. Mean age of the study population was 69.41 years and were predominantly male (84%). The most common presenting symptom was chest pain (79%) followed by sweating (7%), followed by shortness of breath (5%), giddiness (4%) vomiting (3%) and palpitations (2%). hypertension was commonly seen in elderly (56%) followed by diabetes (39%), smoking (28%), dyslipidaemias (12%), history of CAD (9%) and obesity (6%).  Mortality rate was 26% and maximum (11%) patients belonged to age group >80 years. Conclusion: We conclude that chest pain is the most common presentation in elderly AMI patients, but other atypical symptoms such as shortness of breath, giddiness, vomiting, without chest pain can also be the common presenting signs. Early and prompt management as appropriate should be provided to avoid morbidity and mortality in elderly. Keywords: Clinical Profile, Mortality, Myocardial Infarction, Risk Factors.


Author(s):  
Mritunjay Kumar Mishra ◽  
DVSS Ramavataram ◽  
Tejas Shah

Introduction: Heart attack in medical terminology is generally called as Acute Myocardial Infarction (AMI). When blood flow is abruptly cut-off to the heart muscle, it damages the myocardial tissue. This could be the consequence of blocked coronary arteries. The plaque formed due to the deposition of cholesterol and other fatty material over a period of time is the leading cause of this blockage. Aim: To assess the level of Prothrombin Time (PT) and activated Partial Thromboplastin Time (aPTT) in cardiac and non-cardiac chest pain and their association to Body Mass Index (BMI). Materials and Methods: The present study was an observational case-control type of study which included 100 subjects of age group 30-65 years from March 2019 to April 2020. Out of them 50 were non-cardiac chest pain individuals which were control and 50 Cardiac chest pain arrived within 6-8 hours of chest pain who suspected to be Myocardial Infarction (MI) from Emergency Department, Dhiraj General Hospital, Gujarat, India. BMI was calculated by height and weight. PT and aPTT analysis was carried out using STAGO-S.A.S. coagulation analyser. Results: There were increased levels of PT and aPTT (statistically significant) in AMI cases compared to corresponding age and sex matched controls (p<0.0001). Pearson correlation analysis in AMI patients, a slightly positive correlation between BMI and aPTT was observed (r=0.19, p<0.001) and also between PT and aPTT (r=0.66, p<0.001). Conclusion: There was a slightly positive correlation found between BMI and aPTT which indicated that the weight and height of the patients do not affect the plasma PT and aPTT levels on anticoagulant therapy.


2019 ◽  
Vol 9 (2) ◽  
pp. 19-26
Author(s):  
Maryam A. Maryam A. Jabali ◽  
Rana A. Nabalawi Nabalawi ◽  
Ibtihal O. Alsahabi ◽  
Maram F. Almutairi ◽  
Fatimah I. Alsannat ◽  
...  

Objectives: This study aimed to assess the clinical profile of myocardial infarction in a tertiary care hospital in Saudi Arabia, and to determine the differences in presentation, risk factors, complications, and mortality between old and young patients. Methods: Retrospective analysis of demographic and clinical data of adult myocardial infarction patients treated in King Abdulaziz University Hospital between 2010 and 2018. Results: A total of 543 acute myocardial infarction patients (79.4% males) were included in the analysis. There were 64 patients aged ≤ 45 years and 479 patients aged > 45 years. The most common presenting symptom was chest pain in both groups. Current smoking was the most common risk factor in the younger group, whereas diabetes mellitus and hypertension were the most common risk factors in the older group. On electrocardiography, ST-elevation myocardial infarction was more common in the younger group. Mitral regurgitation, followed by congestive heart failure, were the most common complications in both groups. The overall mortality rate was low, but it was higher in the older group. Conclusion: Risk factors and electrocardiogram findings differ significantly between younger (≤ 45 years) and older (> 45 years) patients. Smoking cessation must be stressed in young adults. Population awareness regarding the modifiable risk factors of myocardial infarction could help in decreasing its incidence.


2018 ◽  
Vol 5 (3) ◽  
pp. 738
Author(s):  
Ashu Gupta ◽  
Arun Joshi ◽  
Ashok Kumar ◽  
Paramjeet Singh

Background: Cardiovascular disease is a major global health problem reaching epidemic proportions. Along with the developed nations, underdeveloped and developing countries are now facing this burden. Keeping this in mind various emerging risk factors in patients with documented evidence of acute myocardial infarction attending a tertiary care hospital in the Kumaon region of Uttarakhand were studied.Methods: This study is a prospective study done in the department of Medicine, Sushila Tiwari Government Hospital, Haldwani over a period of 2 years. Patients were enrolled from the Medical Emergency/ OPD who had documented evidence of Acute Myocardial Infarction. Informed consent was taken from each study subject.Results: The mean age was 54.27 years (SD- 13.062). Among the risk factors, high triglyceride is significantly higher in younger patients as compare to older patients. Lipid profile distribution when they compare to any addiction, it has been found in the study that LDL is significantly higher in those who were having any addiction. Hypertension was significantly higher in patients who smoke (p=0.04). The major contributing risk factor was any addiction (smoking, alcohol, tobacco consumption in any form) followed by dyslipidemia.Conclusions: The challenge is to develop appropriate strategies to prevent coronary artery diseases and promote healthy lifestyles.


2018 ◽  
Vol 5 (6) ◽  
pp. 1432
Author(s):  
Abhishek Kamendu ◽  
Ahmad Nadeem Aslami

Background: Cardiovascular diseases are the most common diagnosis in the elderly, and the first cause of death in men and women over 60 years. It is not clear if the risk factors of acute myocardial infarction (AMI) are different in elderly and non-elderly people. The aim of this study was to compare the prevalence of risk factors of acute myocardial infarction between elderly and non-elderly patients who had been admitted to hospital for the first attack of acute myocardial infarction (AMI).Methods: A retrospective study was done in Narayan Medical College and Hospital, Jamuhar, Sasaram, Bihar from January 2017 to December 2017. Study population were all patients who were admitted due to AMI in medicine ward. Patients were selected as per World Health Organization guidelines. The patients were divided into two groups, non-elderly patients of <60 years and elderly patients of ≥60 years.Results: Among different risk factors, diabetes and hypertension were more common in elderly than their non-elderly counterparts, and male gender, smoking and family history of ischemic heart disease was more common in non-elderly patients than elderly ones.Conclusions: This study provide vital information on young AMI patients amongst the diverse population of north India and will help to guide the treating physicians and the health care system to adopt appropriate steps directed towards primary and secondary prevention of AMI in young patients of this region, especially smoking cessation, which is the commonest modifiable risk factor, in their most productive years of life.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoko Takedani ◽  
Tsukasa Nakamura ◽  
Noriko Fukiwake ◽  
Toshihiro Imada ◽  
Junji Mashino ◽  
...  

Abstract Background Antibiotic-associated diarrhea (AAD) is a common problem among elderly inpatients because many elderly patients are admitted for pneumonia or other conditions that necessitate antibiotic treatment. In the super aging population, more patients are suffering from pneumonia than before, but the incidence or risk factors for AAD among many elderly patients have not been well scrutinized. Methods We conducted a retrospective cohort study of elderly patients diagnosed with pneumonia from April 2014 to March 2019 who were admitted to the Department of General Medicine of a Tertiary Care Hospital in Japan. Patients (≥ 65 years of age) who were diagnosed with bacterial pneumonia or aspiration pneumonia and treated with antibiotics were included. We defined AAD by diarrhea with more than three loose or watery stools per day and included patients who had these symptoms for either one day or two or more consecutive days. We also assessed the length of hospital stay and in-hospital mortality. The potential risk factors for AAD included age, sex, body weight, body mass index, smoking, alcohol, activities of daily living (ADL), comorbidities, vital signs, laboratories, the severity of pneumonia, antibiotic and other medication use. Results There were 1,067 patients, the mean age was 83 years, and men accounted for 59 %. β-Lactamase inhibitors were frequently prescribed antibiotics in 703 patients (66 %), and proton pump inhibitors (PPIs) were also commonly administered (48 %). AAD developed in 322 patients (30 %). The multivariate logistic regression model showed that β-lactamase inhibitors (OR 1.43, 95 % CI 1.05–1.95) and PPIs (OR 1.37, 95 % CI 1.03–1.83) were associated with AAD as well as age (OR 1.03 per year, 95 % CI 1.01–1.05). Conclusions AAD was common among elderly inpatients with pneumonia, and β-lactamase inhibitors and PPIs were associated with AAD. Strict use of such medication should be considered to decrease the risk of AAD.


2013 ◽  
Vol 20 (03) ◽  
pp. 332-340
Author(s):  
ATIF SITWAT HAYAT ◽  
MUHAMMAD ADNAN BAWANY ◽  
JAWAD AHMED QADRI ◽  
Kiran Khalil

Background: Ischemic heart disease is the most common cause for complete heart block (CHB) and sudden death. Heartblocks may occur as complications of acute myocardial infarction (AMI) and are associated with increased mortality. The aim of thisstudy is to determine the frequency of complete heart block (CHB) in acute myocardial infarction at a tertiary care hospital. Place andduration: This study was conducted in Cardiology Department of Liaquat University of Medical and Health Sciences from 1st August2009 to 31st January 2010. Study Design: Cross sectional and descriptive study. Materials and Methods: ST segment elevation equal toor more than 1mm (0.1mv) in two of these leads II, III and aVF. Rise in serum creatinine kinase level (CPK Level) more than twice thenormal value along with CK-MB fraction more than 6% of CPK value. Patients with history of chest pain, shortness of breath, nausea,vomiting and unconsciousness were enrolled in the study. The cardiac enzymes tropinin T was also performed at bed side by venousblood sample. Results: Total of 87 patients were included, prevalence of heart blocks was 27.58%. Anterior wall MI was in 50(57.5%)patients. Of these, 13(54.2%) had complete heart block. Inferior wall MI was in 37(42.5%) cases, of these, 11(45.8%) were found withcomplete heart block. There was no significant difference between anterior wall MI and inferior wall MI with complete heart block (P value> 0.05). Mortality was 2.3% with anterior wall MI. Conclusions: Development of complete heart blocks has important prognosticsignificance. Complete heart block was frequent complication of myocardial infarction.


Author(s):  
CH Karthik Reddy ◽  
Mahesh Krishnamurthy ◽  
Ashray Vasanthapuram ◽  
Girish Narayan ◽  
SS Narendra

Introduction: The incidence of Acute Coronary Syndrome (ACS) in the young has been increasing globally. Research in this population has been limited in developed countries or urban areas in developing countries. Identifying the various epidemiologic features in this age group is crucial to understand the disease. Aim: To describe the clinical characteristics of young adults presenting with ACS in a rural tertiary care hospital. Materials and Methods: This cross-sectional study included 50 patients diagnosed with ACS. Data were collected from consecutive patients between the ages of 18 to 45 years diagnosed with ACS between January 2014 to January 2015 in the Emergency Medicine Department of a tertiary care hospital in Davanagere, India. Data were collected on demographic characteristics, risk factors, laboratory tests, and angiographic findings. Range, mean and percentages were calculated for continuous and categorical variables, respectively. A 95% confidence intervals were calculated for all variables. Results: The mean age was 38.1±5.8 years with male preponderance 46 (92%). Risk factors were smoking 36 (72%), diabetes 17 (34%), hypertension 6 (12%) and Body Mass Index (BMI) >23 kg/m2, 36 (72%). Anterior Wall Myocardial Infarction (AWMI) was observed in 35 (70%) of subjects with angiography revealing Single Vessel Disease (SVD) 28 (56%), Double Vessel Disease (DVD) 5 (10%), Triple Vessel Disease (TVD) 3 (6%) and Myocardial Infarction with Non-Obstructive Coronary Artery Disease (MINOCA) 11 (22%). Three patients died during their course of treatment before initiating an interventional procedure. Conclusion: Smoking, diabetes mellitus and elevated BMI are associated with ACS among young patients. Interventions targeting these risk factors among younger individuals should be developed.


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