[Acute coronary syndrome in older people]
D Eckner1, S Popp2, S Wicklein3
1Kardiologie, Klinikum Nürnberg Süd, Paracelsus Medizinische Privatuniversität, Breslauer Str. 201, 90471, Nürnberg, Deutschland. dennis.eckner@klinikum-nuernberg.de.
Insights
Acute coronary syndrome (ACS) presents unique diagnostic and treatment challenges in the elderly. Specialized care, like certified chest pain units, is crucial for improving outcomes in older patients with chest pain.
Area of Science:
- Cardiology
- Geriatric Medicine
Background:
- Acute coronary syndrome (ACS) encompasses ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation ACS (NSTE-ACS), and unstable angina.
- ACS diagnosis and management in the elderly population present distinct challenges compared to younger patients.
Purpose of the Study:
- To highlight the specific diagnostic and therapeutic considerations for acute coronary syndrome in elderly individuals.
- To emphasize the importance of tailored strategies and specialized personnel for managing ACS in older adults.
Main Methods:
- Review of diagnostic modalities including anamnesis, laboratory findings, electrocardiogram (ECG), echocardiography, and angiography.
- Consideration of age-specific differences in ACS presentation and management.
Main Results:
- Elderly patients with ACS require careful evaluation due to potential differences in symptom presentation and diagnostic findings.
- Adherence to evidence-based strategies and utilization of trained personnel are vital for improving prognosis.
Conclusions:
- Implementing certified chest pain units can streamline diagnostics and treatment for ACS, particularly in the elderly.
- Optimized care pathways are essential for improving the quality of life and reducing mortality and morbidity in older adults with ACS.
Abstract:
The acute coronary syndrome (ACS) is subdivided into ST segment elevation myocardial infarction (STEMI), non-ST segment elevation acute coronary syndrome (NSTE-ACS) and unstable angina pectoris. It poses a particular challenge in terms of diagnostics and treatment, especially in the elderly. Starting with the possibly difficult anamnesis, through the laboratory chemical findings up to special features in the electrocardiogram (ECG), echocardiography and angiography, these patients should be considered in some ways different to the younger population. Because of the mortality and morbidity after ACS, especially in old age, it is important to adhere to evident strategies in diagnostics and treatment and to employ specially trained personnel for people with acute chest pain in order to improve the prognosis and quality of life. A first important step is to provide certified chest pain units which ensure smooth diagnostics and treatment and thus positively influence the clinical decision-making processes.
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