JELLAD A, LAGREN A, KHARAT K, BEN HALIMA N.

Department of cardiology , IBN ELJAZZAR hospital Kairouan Tunisia

Correspondance: Jellad Alaeddine from Tunisia This email address is being protected from spambots. You need JavaScript enabled to view it.

Background: Due to high mortality and the increasing aging population, acute myocardial infarction in the elderly is a public health issue; the event is often marked by severe major complications that influence the prognosis in the short and medium term.

Methods: We report a descriptive retrospective study involving 120 patients (55 men and 65 women) aged 75 or more admitted to the cardiology department Kairouan (Tunisia) for a myocardial infarction. They are collected between 2002 and 2013.

Results:The incidence of myocardial infarction in patients over 75 years between 2002 and 2013 is 14.6% .the age means of the population is 78.8±3.05 years, ranging from 75 to 94 years. Hypertension is the most common risk factor found: 65% while 32.5% were diabetics and 16.7% were smokers. Only 40.8% of the population were supported in the first 06 hours while 13.4% after 12 hours. Among 120 patients, reasons for admission to the ED included chest pain( 62.5%) ,  digestive symptoms 16.7%, dyspnea 8.3%, malaise 8.3 % and vigilance disorders in 4.2% of cases. Compared with those who presented with chest pain , patients admitted for other reasons are more women (p < 0.01) , diabetics (p < 0.01) having kidney failure(p=0.03), they waited longer before going to the hospital ( prehospital delay >12 hour: 31.5 % vs 6.8 % p<0.01), were less likely to receive reperfusion therapy ( 25.6 % vs 56 % p<0.01) and had a higher intrahospital mortality rate (41 % vs 13 % p<0.01).

Conclusion: Atypical clinical symptoms of STEMI are common and severe among elderly patients in emergency department (ED). Thus, rapid provision of an electrocardiogram to all elderly patients admitted to the ED is essential, even in the absence of cardiovascular symptoms.

Keywords: Myocardial infarction, elderly patients, clinical presentation.