EFFECTIVENESS OF MEDICAL REHABILITATION OF ELDERLY PATIENTS WHO HAVE SUFFERED A MYOCARDIAL INFARCTION

2021 ◽  
pp. 581-585
Author(s):  
А.Н. Гращенкова ◽  
С.Н. Пузин ◽  
О.Т. Богова ◽  
В.Н. Потапов ◽  
Е.Е. Ачкасов ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Elderly Patients ◽  
The Elderly ◽  
Medical Rehabilitation ◽  
Surgical Interventions ◽  
Treatment And Prevention ◽  
Therapy Program ◽  
Adaptive Mechanisms ◽  
Diagnostic Complex ◽  
Mechanical Therapy

На всех этапах восстановления после инфаркта миокарда (ИМ) увеличение физической активности пациентов пожилого возраста - одна из важных составляющих реабилитационного процесса. Безусловно, на ранних стадиях ИМ определенные ограничения физической активности позволяют уменьшить нагрузку на миокард, снизить его потребности в кислороде и создать условия для скорейшего заживления. В последующем, в зависимости от динамики и показателей работы сердечно-сосудистой системы, пациента пожилого возраста переводят с одной ступениактивностинадругую, оцениваютуровень АД, ЧСС, наличие аритмии, данные электрокардиограммы, данные эхо-КГ показателей, а также индивидуальную переносимость нагрузок. На сегодняшний день для медицинской реабилитации пациентов пожилого возраста, перенесших ИМ, актуальным является применение различных вариантов механотерапии. Представляет интерес применение механотерапии по программе комплекса David Back Concept (силовая тренировка). Он представляет собой комплект из тренажеров для работы над мышцами спины. Настоящий лечебно-диагностический комплекс предназначен для диагностики, лечения и профилактики патологий опорно-двигательной системы, а также для реабилитации пациентов после хирургических вмешательств и травм позвоночника. Для восстановления физического статуса до оптимально достижимого уровня, определяемого возможностями адаптационных механизмов пожилого человека, в программе медицинской реабилитации пациентов пожилого возраста с ИБС и после перенесенного ИМ нами применен программный комплекс David Back Concept и оценено его влияние на гемодинамические показатели. At all stages of recovery after myocardial infarction (MI), the expansion of physical activity of elderly patients is one of the most important components. Of course, certain restrictions can reduce the load on the myocardium, reduce its oxygen needs and create conditions for early healing. Subsequently, depending on the dynamics and indicators of the cardiovascular system, the elderly patient is transferred from one stage of activity to another, the level of blood pressure, the number of heartbeats, the presence of arrhythmia, electrocardiogram data, EchoCG data, as well as individual load tolerance are evaluated. To date, there is a huge selection of optimal options for selecting methods of medical rehabilitation for elderly patients who have suffered a MI, and one of them is mechanotherapy. The mechanical therapy program of the David Back Concept complex - strength training is a set of simulators for working on the back muscles. The medical and diagnostic complex is designed for the diagnosis, treatment and prevention of pathologies of the musculoskeletal system, as well as for the rehabilitation of patients after surgical interventions and spinal injuries. Medical rehabilitation of elderly patients with coronary heart disease and after a MI through mechanotherapy, the program of the David Back Concept complex, provides for the restoration of their physical and social status to an optimally achievable level, determined by the capabilities of adaptive mechanisms.

scholarly journals Acute myocardial infarction in elderly patients: comparative analysis of the predictors of mortality. The elderly versus the young

2002 ◽  
Vol 79 (4) ◽  
pp. 369-374 ◽  
Author(s):  
Marisa F. Leal ◽  
Newton Fernando Stadler de Souza Filho ◽  
Hermínio Haggi Filho ◽  
Estela Regina Klosoviski ◽  
Eva Cantalejo Munhoz
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Comparative Analysis ◽  
Elderly Patients ◽  
The Elderly ◽  
Predictors Of Mortality

Intravenous Enoxaparin Versus Unfractionated Heparin in Elderly Patients Undergoing Primary Percutaneous Coronary Intervention

Angiology ◽  
2016 ◽  
Vol 68 (1) ◽  
pp. 29-39 ◽  
Author(s):  
Zhenyu Liu ◽  
Johanne Silvain ◽  
Mathieu Kerneis ◽  
Olivier Barthélémy ◽  
Laurent Payot ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Elderly Patients ◽  
Unfractionated Heparin ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
The Elderly ◽  
Minor Bleeding ◽  
End Point ◽  
Percutaneous Coronary

Elderly (≥75 years old) patients with ST-segment elevation myocardial infarction (STEMI) have higher ischemic and bleeding risk compared with those <75 years old. We investigated the efficacy and safety of intravenous (IV) enoxaparin versus IV unfractionated heparin (UFH) in elderly patients undergoing primary percutaneous coronary intervention (PCI) for STEMI. A prespecified analysis of the Acute Myocardial Infarction Treated with Primary Angioplasty and Intravenous Enoxaparin or Unfractionated Heparin to Lower Ischemic and Bleeding Events at Short- and Long-term Follow-up (ATOLL) study was performed examining the 30-day outcomes in the elderly patients. Of the 165 elderly patients in the ATOLL study, 85 patients received IV enoxaparin 0.5 mg/kg and 80 patients received IV UFH. Intravenous enoxaparin did not reduce the primary end point, the main secondary efficacy end point, major bleeding, major or minor bleeding, and all-cause mortality compared with IV UFH. The rate of minor bleeding (5.9% vs 22.8%, Padjusted = .01) was significantly lower with IV enoxaparin compared with IV UFH. Intravenous enoxaparin appears to be a safe alternative to IV UFH in primary PCI of the elderly patients with STEMI.

scholarly journals CLINICAL PRESENTATION OF ACUTE MYOCARDIAL INFARCTION IN ELDERLY PATIENTS

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Rajesh Kumar Singhal ◽  
Harsha Kumar Gowardhan
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Elderly Patients ◽  
The Elderly ◽  
Shortness Of Breath ◽  
Cross Sectional ◽  
Clinical Presentations ◽  
Myocardial Infraction

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.

scholarly journals Epidemiology, Risk Factors, Clinical Current, Diagnostics, Principles Of Treatment And Prevention Of Acute Myocardial Infarction In The Elderly And Old Population (Review)

2020 ◽  
Vol 02 (11) ◽  
pp. 106-114
Author(s):  
Rakhmatova Dilbar Baxriddinovna ◽  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiovascular Diseases ◽  
Medical Science ◽  
The Elderly ◽  
Epidemiological Studies ◽  
Scientific Data ◽  
Treatment And Prevention ◽  
Principles Of Treatment ◽  
Social Importance

In view of the special medico-social importance of cardiovascular diseases, their prevention is one of the most important tasks facing medical science and the health care system. Ischemic heart disease and its most serious complication, acute myocardial infarction, is the main and most dangerous disease of the cardiovascular system. Epidemiological studies and screening measures for the prevention of cardiovascular diseases contain scientific data that can not only reduce the incidence, but, undoubtedly, prolong the life of the elderly and senile population.

scholarly journals The influence of burdened comorbid status on treatment outcomes of injured elderly patients with severe traumatic brain injury

2019 ◽  
Vol 178 (1) ◽  
pp. 30-33
Author(s):  
Ju. A. Shcherbuk ◽  
V. I. Zakharov ◽  
A. Ju. Shcherbuk ◽  
V. V. Donskov ◽  
E. V. Cherepanova ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Elderly Patients ◽  
Treatment Outcomes ◽  
Severe Traumatic Brain Injury ◽  
Postoperative Period ◽  
The Elderly ◽  
Medical Rehabilitation ◽  
Severe Tbi

Theobjectivewas to research the effect of burdened comorbid status on the course of severe traumatic brain injury (TBI) in the elderly.Material and methods. 243 injured elderly patients (182 men and 61 women) with severe TBI and burdened comorbid status.Results. It was found that the postoperative period was characterized by more severe course of injury associated with the development of infectious and inflammatory complications.Conclusion. Early medical rehabilitation does not have a significant impact on the state of comorbid status, but is important in the prevention of infectious and inflammatory complications due to the early activation of the victims and the elimination of hypodynamia in intensive care and neurosurgical departments.

scholarly journals Bivalirudin Versus Heparin Monotherapy in Elderly Patients With Myocardial Infarction

2020 ◽  
Vol 13 (4) ◽  
Author(s):  
Axel Wester ◽  
Rubina Attar ◽  
Moman A. Mohammad ◽  
Nazim Isma ◽  
Stefan James ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Elderly Patients ◽  
Major Bleeding ◽  
Coronary Intervention ◽  
The Elderly ◽  
End Point ◽  
St Segment ◽  
Increased Risk ◽  
Percutaneous Coronary

Background: Elderly patients with acute myocardial infarction undergoing percutaneous coronary intervention are at increased risk of both ischemic and bleeding complications. The optimal anticoagulation strategy in these patients is uncertain. Therefore, we compared bivalirudin to heparin monotherapy in a contemporary cohort of such patients. Methods: A prespecified subgroup analysis of elderly patients with myocardial infarction (≥75 years) from the VALIDATE-SWEDEHEART trial (Bivalirudin Versus Heparin in ST-Segment and Non–ST-Segment Elevation Myocardial Infarction in Patients on Modern Antiplatelet Therapy in the Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies Registry Trial) was performed. In the trial, patients were randomized to either bivalirudin or heparin monotherapy during percutaneous coronary intervention, with mandatory potent P2Y12 inhibition, routine radial artery access, and only bail-out glycoprotein IIb/IIIa inhibition. Kaplan-Meier event rates were assessed for the primary end point, consisting of a composite of all-cause death, myocardial reinfarction, or major bleeding, within 180 days. Results: The elderly (n=1592) had more than twice the risk of all events compared with younger patients (n=4406). Baseline and periprocedural characteristics were equal between bivalirudin (n=799) and heparin (n=793) treated patients ≥75 years. No differences were found in the elderly between bivalirudin and heparin monotherapy regarding the primary end point (180-day all-cause death, myocardial reinfarction, or major bleeding), the individual components of the primary end point, definite stent thrombosis, or stroke. Conclusions: In this prespecified subgroup analysis of the VALIDATE-SWEDEHEART trial, elderly patients with myocardial infarction had a highly increased risk of all events. However, no difference in outcomes could be observed with an anticoagulation strategy with either bivalirudin or heparin as monotherapy in this patient group.

scholarly journals Inguinal hernias in elderly patients. Strategy for choosing a surgical treatment method

2021 ◽  
pp. 71-78
Author(s):  
S. M. Smotryn ◽  
S. A. Zhuk ◽  
V. S. Novitskaya ◽  
A. V. Kopytski
Keyword(s):  
Surgical Treatment ◽  
Elderly Patients ◽  
Inguinal Canal ◽  
The Elderly ◽  
Treatment Method ◽  
Surgical Interventions ◽  
Inguinal Hernias ◽  
Inguinal Herniation ◽  
Anatomical Parameters

Objective: to evaluate the existing approaches to the treatment of inguinal hernias in the elderly and to propose a strategy for choosing the method of surgical treatment taking into account the metric assessment of the state of the topographical and anatomical parameters of the inguinal canal.Materials and methods. The analysis of surgical interventions for inguinal hernias in elderly patients in surgical in-patient clinics of the Grodno region over 2018–2019 was carried out. The morphometric parameters of the inguinal canal being determinants for choosing the method of hernioplasty were studied in 39 elderly patients.Results. The coefficient for choosing the method of inguinal herniation (K) has been proposed. It is calculated by the formula: К = h : m, where h is the height of the inguinal space (mm), m is the total thickness of the upper wall of the inguinal canal (mm). At K>4.83 they choose atension methods of hernioplasty.Conclusion. The use of the coefficient for choosing the method of inguinal hernioplasty has made it possible to reduce the number of recurrent hernias in the long-term postoperative period from 5.7 % to 2.0 % of cases.

scholarly journals Acute Myocardial Infarction During Hospitalization for Community-Acquired Pneumonia in Geriatric Patients: A Cross-Sectional Study

2020 ◽  
Author(s):  
Yu Kang ◽  
Xiang-Yang Fang ◽  
Dong Wang ◽  
Xiao-Juan Wang
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Respiratory Failure ◽  
Elderly Patients ◽  
Hospital Mortality ◽  
Geriatric Patients ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Cross Sectional

Abstract Background: Community-acquired pneumonia (CAP) and acute myocardial infarction cardiovascular (AMI) are two important health issues in elderly. Little is known regarding characteristics of AMI in elderly hospitalized for CAP. Therefore, we investigated the prevalence, characteristics compared with younger patients, impact on clinical outcomes and risk factors of AMI during hospitalization for CAP in geriatric patients.Methods: 11009 adult inpatients consisted of 5111 elderly patients≥ 65 years and 5898 patients＜65 years in respiratory ward and 1095 inpatients ≥65 years in geriatrics ward diagnosed with CAP were retrospectively analyzed by electronic medical records. Results: 159 (3.1%) elderly patients in respiratory ward and 77 (7.0%) patients in geriatrics ward experienced AMI during hospitalization for CAP. AMI were more frequently seen in elderly patients (3.1% vs. 1.0 %), Patients≥65 years who experienced AMI during hospitalization for CAP had higher percentage of respiratory failure (P = 0.001), hypertension (P = 0.008), dyspnea (P=0.046), blood urea nitrogen (BUN)≥7mmol/L (P < 0.001), serum sodium <130 mmol/L(P = 0.005) and had higher in-hospital mortality compared to patients＜65 years (10.1% vs. 6.6%). AMI was associated with increased in-hospital mortality (odds ratio, OR, with 95% confidence interval: 1.49 [1.24-1.82]; P<0.01). Respiratory failure (OR, 1.34 [1.15–1.54]; P<0.01), preexisting coronary artery disease (OR, 1.31[1.07–1.59]; P = 0.02), diabetes (OR, 1.26 [1.11–1.42]; P = 0.02), BUN (OR, 1.23 [1.01–1.49]; P = 0.04), and impaired consciousness (OR, 1.19 [1.07–1.32]; P = 0.03) were correlated with the occurrence of AMI in the elderly.Conclusions: The incidence of AMI during CAP hospitalization in geriatric patients is notable and have an impact on in-hospital mortality. Characteristics of the elderly differ from the general population. Particular attention should be paid to elderly patients with risk factors for AMI. Our study may represent useful information for clinical strategies aimed at preventing AMI and decreasing mortality in geriatric patients hospitalization for CAP.

scholarly journals Changes in Aerobic Capacity Over Time in Elderly Patients With Acute Myocardial Infarction During Cardiac Rehabilitation

2020 ◽  
Vol 44 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Ki-Hong Kim ◽  
Yun-Chol Jang ◽  
Min-Keun Song ◽  
Hyeng-Kyu Park ◽  
In-Sung Choi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Elderly Patients ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Coronary Intervention ◽  
The Elderly ◽  
Elderly Group ◽  
Target Heart Rate ◽  
Metabolic Equivalents

Objective To test the hypothesis that a longer duration of phase II cardiac rehabilitation is required to recover the exercise capacity of elderly patients compared to younger patients.Methods We retrospectively reviewed and analyzed the medical records of patients who were referred to our cardiac rehabilitation (CR) center and underwent percutaneous coronary intervention for acute myocardial infarction (AMI). A total of 70 patients were enrolled who underwent an exercise tolerance test (ETT) 3 weeks after the occurrence of an AMI (T0), 6 weeks after the first ETT (T1), and 12 weeks after the first ETT (T2). Patients older than 65 years were assigned to the elderly group (n=24) and those aged 65 years and younger to the younger group (n=46). Both groups performed center-based or home-based CR for 12 weeks (3 times per week and 1 session per day). Exercise intensity for each individual was based on the target heart rate calculated by the Karvonen formula. The change in maximal metabolic equivalents (MET<sub>max</sub>) of the two groups was measured at each assessment point (T0, T1, and T2) to investigate the recovery of exercise capacity.Results The younger group showed improvement in MET<sub>max</sub> between T0 and T1. However, MET<sub>max</sub> of the elderly group showed no significant improvement between T0 and T1. The exercise capacity, measured with MET<sub>max</sub>, of all groups showed improvement between T0 and T2.Conclusion Elderly patients with AMI need a longer duration of CR (>6 weeks) than younger patients with AMI.

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