Presenting symptoms of acute coronary syndrome in older and younger adults in Trinidad & Tobago

BACKGROUND AND AIM: Acute Coronary Syndrome (ACS) is a major cause of mortality in Trinidad and Tobago. As life expectancy increases, Emergency Departments in Trinidad and Tobago are admitting more older patients (age ≥ 65). Previous studies have demonstrated differences in the presenting symptoms between older and younger patients with ACS. However, to our knowledge, no such work has been done on older patients in the developing world. The aim of this study was to determine the differences in the reported symptoms of ACS between the older patients (age ≥ 65) and younger adults (age 18 – 64) in the ED. The primary objective was to compare the differences in frequency of symptoms of ACS between the older and younger adults. A secondary objective was to determine if differences in reported symptoms also exist between older men and older women. CONCLUSIONS: This study demonstrates significant differences in symptoms between older and younger patients as well as between older men and women. Clinical assessment of older patients with ACS should be tailored to their common presenting features. Further work is needed to develop a clinical assessment tool for older patients with ACS that accounts for differences in presentation.