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in the heart’s oxygen needs and an
increased tendency to form blood clots.

Sensory decline due to aging may
alter hearing, vision and pain sensations.

Kidney function also declines with age,
with more than one-third of people 65
and older having chronic kidney disease.

As people age, they are often
diagnosed with health conditions that
may be worsened by ACS or complicate
existing ACS. As these chronic condi-
tions are treated, medications prescribed
may result in unwanted interactions or
medications that treat one condition but
may worsen another.

“Geriatric syndromes and the complex-
ities of their care may undermine the
eff ectiveness of treatments for ACS, as
well as the resiliency of older adults
to survive and recover,” Damluji said.

“A detailed review of all medications,
including supplements and over-the-
counter medicines, is essential, ideally in
consultation with a pharmacist who has
geriatric expertise.”
Steps for Heart-Attack Care
and Follow-Up
• Call 911 if you notice someone expe-
riencing heart-attack warning signs.

These include chest discomfort, dis-
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comfort in other areas of the upper
body (one or both arms, back, neck,
jaw or stomach), shortness of breath
or other symptoms such as a cold
sweat, nausea or lightheadedness.

• Consider treatment needs for co-ex-
isting conditions. An individualized,
patient-centered approach is best for
older adults.

• Get input from multiple specialists,
including a pharmacist, to manage
care and medications.

• People with cognitive diffi culties and
limited mobility may benefi t from a
simplifi ed medication schedule, with
fewer doses per day and 90-day sup-
plies of medications so fewer refi lls
are necessary.

• The goals of care for older people with
ACS should extend beyond clinical
outcomes and focus on quality of life
and the ability to live independently.

• Do-not-resuscitate orders should be
discussed before any surgery or pro-
cedure. ■
For more information about managing
ACS in older adults, visit Heart.org.

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