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老年人心肌梗塞如其它脏器疾患一样,比年轻人缺少典型症状,诊断相当困难,所谓的无痛性心肌梗塞超过50%,是通过尸检才发现有陈旧性的心肌梗塞的。有时左前胸部、心窝部、左肩、左腕等无疼痛感,也会出现眩晕和错乱状态之类的脑供血不足引起的症状,乍一看不少被认为是脑血管障碍。另外,也有以急剧心衰为首发症状(日本以胸痛以外症状发病者达52%以上)。老年人如有原因不明的心衰和低血压时,首先应想到心肌梗塞;心电图也较少出现青年人那种典型的 ST-T 段升高,有时只靠血中 MB 型肌酐激酶上升,作为唯一诊断依据。据统计,缺血性心脏病死亡的80多岁的老年人比50岁以下者多达20～50倍左右,可见增龄同心肌梗塞的关系密切。其他危险因子还有性别(男性要比女性易患病死亡)、高血压(尤其收缩期高血压)、心肌梗塞既往史、高脂血症、吸烟、脱水、血粘滞性增高、饮食生活、气候(寒冷)、运动等。其中高脂血症仍然是很重要的因素。
Elderly myocardial infarction, like other organ diseases, is more difficult to diagnose than the typical symptoms of young people. The so-called painless myocardial infarction is over 50% and an old myocardial infarction is found by autopsy. Sometimes left anterior chest, heart and socket, left shoulder, left wrist and other painless, there will be symptoms of dizziness and confusion caused by insufficient blood supply to the brain, at first glance considered a lot of cerebral vascular disorders. In addition, there are also rapid heart failure as the first symptom (Japan to symptoms other than chest pain, up to 52% or more). Elderly people with unexplained heart failure and hypotension should first think of myocardial infarction; electrocardiogram is also less typical of young people that the typical ST-T segment increased, and sometimes only by blood MB creatinine kinase increased, as The only basis for diagnosis. According to statistics, ischemic heart disease death of 80-year-olds than those under 50 years old as much as 20 to 50 times, showing that aging with myocardial infarction is closely related. Other risk factors were gender (men were more likely to die than women), hypertension (especially systolic hypertension), previous history of myocardial infarction, hyperlipidemia, smoking, dehydration, increased blood viscosity, dietary life, Climate (cold), exercise and so on. Hyperlipidemia is still a very important factor.