[Acute myocardial infarct in the aged. Omissions in treatment]

The pre-hospital phase of acute myocardial infarction may be of crucial importance for the further fate of the subject. Mortality of old people seems to be twice that of middle aged persons during the pre-hospital phase of acute infarction. This may be due partially to the longer duration of latency between onset of symptoms and arrival at the hospital of older patients causing waste of time especially for resuscitation from lethal arrhythmias. The delay of therapy is promoted by difficulties in diagnosis due to lack of typical pain often veiled by other symptoms and failure of the electrocardiogram in old patients. Need of urgent hospitalization for reduction of pre-hospital mortality seems not to have been generally accepted among general practitioners. Standard management of emergency care of patients with suspected myocardial infarction is reviewed.