Fatal myocardial infarction in a state geriatric mental facility

Geriatric patients committed to mental institutions often die from infections, neoplasia, drug-related disorders, or cardiopulmonary failure. Myocardial infarction is not usually implicated as the cause of death in these patients. In comparison, infarct-related deaths are quite common in normal patients of comparable age. This observation may, in part, be due to the fact that physicians treating psychiatric patients may become preoccupied with the patients' mental state, and pay less attention, inadvertently, to other medical disorders. Also, ischemic heart disease may present in an atypical manner in such patients, thus masking detection by the physician. Careful evaluation and observation of these patients for evidence of ischemic heart disease and myocardial infarction are essential to their care, because early detection of such disorder and prompt therapy may save the patient's life.