Management of myocardial infarction in the very elderly - Impact of clinical effectiveness on practice

The presentation of myocardial infarction in the elderly is often atypical and there is therefore a broad range of clinical presentations where this d iagnosis should be actively considered and the appropriate investigations a rranged. The early use of aspirin and thrombolytic therapy has revolutionis ed management and efforts should be made to employ these interventions wher ever possible. We present the results of an audit showing how the introduct ion of local guidelines improved the early management of myocardial infarct ion in the elderly. We also found that in this group of patients cardiac en zyme assays were more useful in establishing the diagnosis that the electro cardiogram.