Bayer A J, Chadha J S, Farag R R, Pathy M S
J Am Geriatr Soc. 1986 Apr;34(4):263-6. doi: 10.1111/j.1532-5415.1986.tb04221.x.
The symptoms associated with acute myocardial infarction in a series of 777 elderly hospitalized patients are reviewed. Their ages ranged from 65 to 100, with a mean of 76.0 years. The spectrum of presentation changed significantly with increasing age. Chest pain or discomfort were less frequently reported, although present in the majority of patients up to 85 years. Syncope, stroke, and acute confusion became more common and were often the sole presenting symptom. Shortness of breath, although the most frequently reported symptom in the absence of chest pain, was equally common at all ages. Thus, in patients aged 85 years or over, "atypical" presentation of myocardial infarction became the rule, and in the very old the clinician must be prepared to screen for the diagnosis in most acutely ill patients.
对777名住院老年患者的急性心肌梗死相关症状进行了回顾。他们的年龄在65岁至100岁之间，平均年龄为76.0岁。随着年龄的增长，症状表现范围发生了显著变化。胸痛或不适的报告频率较低，尽管在85岁以下的大多数患者中都有出现。晕厥、中风和急性意识模糊变得更为常见，且常常是唯一的首发症状。气短虽然是无胸痛时最常报告的症状，但在各年龄段同样常见。因此，在85岁及以上的患者中，心肌梗死的“非典型”表现成为常态，对于高龄患者，临床医生必须准备好在大多数急重症患者中筛查诊断。
