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Intensive Care for Elderly Patients with Myocardial Infarction: Age-related Comparison of Clinical Features and Outcome

Clinical features of 104 patients 70 years of age and older with myocardial infarction were compared with those of 157 younger individuals. Prior heart disease was common among the elderly patients; 15 % had congestive heart failure, 49% had angina, and 35% had previous myocardial infarction compared with 5, 31, and 20% among younger patients, respectively. Both groups had a similar frequency of atypical chest discomfort (24% of the elderly patients, 20% of the younger patients) and similar values for vital signs at presentation with acute myocardial infarction. The elderly patients had more complications of myocardial infarction; 29% had congestive heart failure, 18% had pulmonary edema, and 7% had cardiogenic shock compared with 14, 4, and 1 % , respectively, in the younger group. Overall mortality was 22% in the elderly group and 5 % in the younger group. Slightly over half of each group received major therapeutic interventions during their intensive care unit stay. Fifty-seven percent of the elderly patients who received interventions survived compared with 90% of the younger patients; however, use of a specific intervention should not be limited by age.