الفهرس 
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Abstract
S
UMMARY
orldwide, ischemic heart disease is an important medical issue, especially in the elderly. Its prevalence increases significantly in the sixth decade of life, becoming the leading cause of death in older people. In the elderly, the classic clinical picture of the disease is frequently absent and they often present with atypical symptoms.
Atypical presentation of the disease means that the patient presented with unusual or no signs and symptoms. In general, the incidence of typical precordial chest pain denoting myocardial ischemia is less common in the elderly. Persons, instead of presenting with typical retrosternal chest pain, often present with atypical symptoms such as dyspnea, diaphoresis, atypical chest pain, palpitation, epigastric pain, syncope, and/or fall. The absence of chest pain can lead to misdiagnosis or delayed diagnosis, which worsens outcomes.
The current study was conducted to measure the frequency of atypical presentation of IHD, their forms, and the frequency of IHD in an elderly patient ≥ 60 years attending Geriatric outpatient clinic in Geriatric hospital in Ain Shams University. The study was a Cross-sectional study and conducted on 280 elderly patients that attend Geriatric outpatient clinic.
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Summary
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The data was collected ”According to European society of cardiology Guidelines (2019)” using: semi structured questionnaire ‗includes sociodemographic and clinical data‘, ECG and electrocardiogram findings. Every participant was asked about (age, sex, marital status, smoking, manifestations of ischemic heart disease, typical and atypical symptoms of IHD were asked in details for every participant, manifestations of heart failure, risk factors as diabetes, hypertension, dyslipidemia, evidence of a history of IHD, medication review. Proper physical examination focused on vital signs, cardiac murmurs, signs of heart failure.
After recruitment, the participants were divided into three groups: non-IHD, typical IHD, and atypical IHD. Frequency of IHD is 38.57% in an elderly attending Geriatric outpatient clinic in Ain Shams University Geriatric hospital.
The frequency of atypical presentations among those IHD elderly is (20.37%). The most common atypical form was dyspnea (54.55%) 12 patients, followed by atypical chest pain (27.27%) 6 patients, epigastric pain (9.09%) 2 patients, and palpitation (9.09%) 2 patients.
Data from this study showed that as age increases, the frequency of atypical IHD presentations increases. Frequency of atypical IHD presentations is more among females.
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Diabetes, hypertension, dyslipidemia, and previous myocardial infarction are all significantly higher among those with atypical IHD. Also, data showed that the number of comorbidities are more among atypical IHD participants.
On comparing the findings of ECG and ECHO of the typical and atypical groups, there was no significant statistical difference between them.
So paying more attention to increase the awareness of people and health care team members about the atypical presentation of IHD in the elderly is very important in early diagnosis and treatment.