Title: ACS in Elderly Patients (Submitted by Dr Katherine Grundmann)<br/>Author: Danya Khoujah<br/><a href='http://umem.org/profiles/faculty/739/'>[Click to email author]</a><hr/><p>
<span style="font-size:12px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="color: rgb(0, 0, 0);">Older patients with acute coronoary syndrome (ACS) are less likely to present with typical ischemic chest pain (pressure-like quality, substernal location, radiating to jaw, neck, left arm/shoulder and exertional component) compared with younger counterparts. </span></span></span></p>
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<span style="font-size:12px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="color: rgb(0, 0, 0);">Typical angina symptoms predictive of acute myocardial infarction (AMI) in younger patients were less helpful in predicting AMI in the elderly population.</span></span></span></p>
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<span style="font-size:12px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="color: rgb(0, 0, 0);">Autonomic symptoms such as dyspnea, diaphoresis, nausea and vomiting, pre-syncope or syncope are more common accompaniments to chest discomfort in elderly ACS patients. </span></span></span></p>
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<span style="font-size:12px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="color: rgb(0, 0, 0);">Symptoms may also be less likely to be induced by physical exertion; instead, they are often precipitated by hemodynamic stressors such as infection or dehydration</span></span></span></p>
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<span style="font-size:12px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="color: rgb(0, 0, 0);"><strong><u>Bottom Line:</u></strong> Keep a high index of suspicion for ACS in older patients as they present atypically.</span></span></span></p>
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Dai X, Busby-Whitehead J, Alexander KP. Acute Coronary Syndrome in the older adults. <em>J Geriatr Cardiol</em>. 2016 Feb;13 (2): 101-108 </div>
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