Acute Myocardial Infarction in the Elderly

Up to half of admissions with myocardial infarction are over 70 years of age. Mortality in this age group is higher than in younger age groups. However, elderly patients are less likely to be managed in an acute coronary care setting. Low dose aspirin should be given to all elderly patients with myocardial infarction. Thrombolytic agents have the greatest effect in the elderly even though they give an increased risk of hemorrhagic stroke. They are underused in the elderly with myocardial infarction for a number of reasons. β-Blockers reduce mortality post infarction and ACE inhibitors improve morbidity and mortality rates in those with evidence of heart failure post infarction. Amiodarone may also be of use as an antiarrhythmic in the post infarction period.