Management of acute myocardial infarction in the elderly

被引:10
作者
Forman, DE
Rich, MW
机构
[1] BROWN UNIV, MIRIAM HOSP, DIV CARDIOL, PROVIDENCE, RI 02906 USA
[2] UNIV WASHINGTON, JEWISH HOSP ST LOUIS, MED CTR, CORONARY CARE UNIT, ST LOUIS, MO USA
[3] UNIV WASHINGTON, JEWISH HOSP ST LOUIS, MED CTR, GERIATR ONCOL PROGRAM, ST LOUIS, MO USA
关键词
D O I
10.2165/00002512-199608050-00005
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
The prevalence of myocardial infarction (MI) is high among the elderly population. Many of the physiological and morphological changes attributable to 'normal' aging predispose older adults to cardiovascular instability, The incidence of both MIs and their associated morbidity and mortality increase with aging. Older MI patients may therefore derive substantial benefit from appropriately selected therapeutic intervention. In fact, given the high morbidity and mortality associated with MI in the elderly, aggressive therapeutic strategies may be particularly warranted. There are a number of age-related cardiovascular changes that contribute to the increasing incidence of MI as adults age. However, age itself is not a contraindication to aggressive therapy. Common MI management options include invasive and pharmaceutical strategies. The relative advantages of angioplasty and thrombolytics must be considered. Other drugs used in the treatment of MI include beta-blockers, ACE inhibitors, nitrates, aspirin, anticoagulants, magnesium, antiarrhythmics and calcium antagonists. Significant peri-infarction complications, including heart failure, hypotension, arrhythmias, myocardial rupture and cardiogenic shock, often occur in older adults. Age-specific management strategies for these complications are reviewed.
引用
收藏
页码:358 / 377
页数:20
相关论文
共 148 条
[1]   THE EFFECT OF THE ANGIOTENSIN-CONVERTING ENZYME-INHIBITOR ZOFENOPRIL ON MORTALITY AND MORBIDITY AFTER ANTERIOR MYOCARDIAL-INFARCTION [J].
AMBROSIONI, E ;
BORGHI, C ;
MAGNANI, B .
NEW ENGLAND JOURNAL OF MEDICINE, 1995, 332 (02) :80-85
[2]   OLDER AGE AND ELEVATED BLOOD-PRESSURE ARE RISK-FACTORS FOR INTRACEREBRAL HEMORRHAGE AFTER THROMBOLYSIS [J].
ANDERSON, JL ;
KARAGOUNIS, L ;
ALLEN, A ;
BRADFORD, MJ ;
MENLOVE, RL ;
PRYOR, TA .
AMERICAN JOURNAL OF CARDIOLOGY, 1991, 68 (02) :166-170
[3]  
[Anonymous], 1987, Lancet, V2, P871
[4]  
[Anonymous], 1994, Circulation, V89, P1545
[5]  
[Anonymous], 1990, LANCET, V336, P65
[6]  
[Anonymous], 1992, JAMA, V268, P2171
[7]  
[Anonymous], 1988, LANCET, V2, P349
[8]  
[Anonymous], 1986, LANCET, V1, P397
[9]  
[Anonymous], 1989, NEW ENGL J MED, V320, P618
[10]  
[Anonymous], 1988, BRIT MED J, V296, P320