Acute Coronary Syndromes in the Elderly
Niels Engberding1, Nanette K Wenger2,3
1Department of Medicine, Division of Cardiology, National Jewish Health, Denver, Colorado, USA.
F1000Research
|October 19, 2017
Summary
Elderly patients with acute coronary syndrome (ACS) face worse outcomes due to delayed recognition and suboptimal treatment. Careful dose adjustment and transitions of care are crucial for improving results in older adults.
Area of Science:
- Cardiology
- Geriatric Medicine
- Clinical Evidence
Background:
- The elderly population exhibits the highest incidence of cardiovascular disease, with acute coronary syndrome (ACS) frequently presenting in this demographic.
- Aging societies will see an increase in ACS cases among older adults, necessitating tailored clinical approaches.
- Older adults often experience poorer outcomes due to atypical ACS presentation, delayed diagnosis, and underutilization of guideline-directed treatments.
Purpose of the Study:
- To review the clinical evidence for acute coronary syndrome (ACS) treatment in the elderly.
- To highlight the challenges and vulnerabilities associated with ACS management in older adults.
- To emphasize the need for optimized treatment strategies and careful clinical attention for elderly ACS patients.
Main Methods:
- Review of existing clinical evidence regarding ACS treatment in elderly patients.
- Analysis of factors contributing to unfavorable outcomes in older adults with ACS.
- Discussion of treatment complexities, including comorbidities, cardiovascular reserve, and pharmacologic management.
Main Results:
- Clinical evidence for ACS treatment in the elderly is less robust compared to younger populations.
- Older adults face higher risks of ischemic complications and treatment-related adverse events.
- Suboptimal guideline-directed ACS treatment is common in the elderly, exacerbating poor outcomes.
Conclusions:
- Elderly patients with ACS require special clinical attention due to their unique vulnerabilities.
- Meticulous dose adjustment of therapies and careful transitions of care can mitigate complications.
- Optimizing ACS treatment and secondary prevention in older adults is critical for improving cardiovascular health outcomes.
More Related Videos
06:39Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
16.9K
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
4.6K
Related Concept Videos
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
487
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
487
01:30Acute Coronary Syndrome I: Introduction
1.1K
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
1.1K
01:30Acute Coronary Syndrome III: Diagnostic Studies
312
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
312
01:30Coronary Artery Disease III: Clinical Manifestations
445
Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
445
01:26Acute Coronary Syndrome V: Nursing Management
382
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
382
01:28Acute Coronary Syndrome IV: Interprofessional Care
315
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
315