Acute MI - Age-related presentations and treatment options

At least 60% of all acute myocardial infarctions (AMIs) occur in patients a ge 65 and older and about one-third in patients older than age 75. The pres entation of AMI is modified by age-related changes in endothelial function, smooth muscle cell activity, diastolic function, and responses to circulat ing catecholamines. Atypical presentations are common in the older patient and require the physician to maintain a high index of suspicion for AMI. EC G findings of ST-segment depression make many older patients ineligible for reperfusion by thromboiytic therapy. Acute and post MI medical therapies a re underused in the older population and should be individualized, based on the presence of comorbid conditions.