Over the last 60 years, congenital heart disease prevalence has increased from 1% to 9-10% in urban areas and has gone from 1% to 4-6% in rural areas.

Risk factors for heart attacks in elderly:

• Family history of heart attacks or cardiac problems
• Diabetes
• High blood pressure
• High cholesterol
• Smoking (even second-hand smoke exposure)
• Alcohol consumption
• Being overweight or obese
• Inactive or sedentary lifestyle

Symptoms of heart attack in elderly:

Experiencing any of these may not necessarily indicate that the person has a heart attack. It is better to leave the clinical decision to the doctor. While it is known that the most common symptom is sudden onset chest pain, many of the elderly do not present this characteristic complaint.

Commonly reported symptoms include:

• Uncomfortable chest pain, heavy pressure or squeezing or sensation of fullness in chest, with pain radiating to neck, jaw and arm.
• Indigestion or heartburn.
• Experiencing shortness of breath.
• Nausea, vomiting, sudden sweating or dizziness.
• Fatigued and noticeable decrease in energy.
• In some cases, acute change in behaviour (delirium).

Steps to reduce heart attacks in elderly

• It is important for people of all ages to eat a healthy diet. If suffering from high blood pressure, they should have a diet low in salts and pickles; consume less oily and fried foods.
• If diabetic, diet should be low in sugars and consume foods with low glycaemic index. It is always a good option to consume fresh fruits and green leafy vegetables and avoid junk food.
• Senior citizens who have been sedentary should start exercising slowly, by taking short walks every day.
• One of the most preventable causes of heart attacks is smoking. It is always better to quit smoking at any age. Limit the amount of alcohol you drink or quit drinking.
• Keep your blood pressure, diabetes and cholesterol in good control.
• Try and lead a stress-free life; visit your doctor on a regular basis.

Steps for caregivers if an elderly has a heart attack outside hospital:

• Have that person sit down, rest and try to keep calm.
• Loosen any tight clothing.
• Keep constantly reassuring them that medical aid is on its way.
• If the person takes any medication for chest pain or heart condition, help them take it.
• Call for help and immediately, take the person to the hospital.

What not to do?

• Do not leave the person alone, except to call for help.
• Do not give anything by mouth, unless a heart medication is prescribed.
• Do not wait to see if the symptoms go away. Take the person immediately to the hospital.

Every minute matters, once a person develops a heart attack; the medical intervention is to get the blood flowing back to the heart. The sooner the treatment is received, once the symptoms of heart attack are noticed, the less damage will be caused to the heart. In most cases, an elderly individual will live through a heart attack, if they treated at the earliest. A delay of even a few minutes can be fatal.

The author is a Consultant Geriatrician at Fortis Hospital, Mulund