Zapfe H, Feldmann S
Aktuelle Gerontol. 1983 Mar;13(2):57-60.
The poor prognosis of myocardial infarction in old people is based almost completely upon clinical observations. But in the case of patients of advancing years it seems likely that the percentage of undiagnosed infarctions-whether due to atypical symptoms or to the fact that the patient is not admitted to hospital-is considerable. To estimate the level of this percentage a clinical-autoptical analysis of 124 decreased with transmural myocardial scars was carried out (mean age of death: 80 years). This reveals that 80% of all myocardials scars had not hitherto been diagnosed. Only 35% of the electrocardiograms showed definite scars, mostly in the case of patients with known myocardial infarction. 22% of deceased had complained about angina pectoris, again mostly patients with known myocardial infarction. In comparison with other studies of people in the same age group, the results are not surprising. This is only explained in part by old people's poor powers of recollection and their limited ability to communicate. These results indicate that the over all prognosis of acute myocardial infarction in old people, which often does not occur in hospital without being diagnosed should be viewed in a more favourable light than clinical results would suggest.
老年人心肌梗死预后较差几乎完全基于临床观察。但对于老年患者而言，未被诊断出的梗死比例似乎相当可观，这可能是由于症状不典型，或是患者未入院治疗所致。为估算这一比例，对124例有透壁心肌瘢痕的死者进行了临床尸检分析（平均死亡年龄：80岁）。结果显示，所有心肌瘢痕中80%此前未被诊断出。只有35%的心电图显示有明确瘢痕，大多是已知有心肌梗死的患者。22%的死者曾诉说过心绞痛，同样大多是已知有心肌梗死的患者。与同年龄组其他人的研究相比，这些结果并不令人意外。这部分是由于老年人记忆力差以及沟通能力有限造成的。这些结果表明，急性心肌梗死在老年人中的总体预后情况应比临床结果显示的更为乐观，因为急性心肌梗死在老年人中常常在未被诊断的情况下就未在医院发生。
