Atypical Presentations

• Definition

  • Some conditions present differently than what you expect or experience in younger population
  • Adds complication to identification of problems
• Acute MI

  • Only ~50% present w/ chest pain, pain in left arm
  • Elderly often present w/ weakness, confusion, syncope, abdominal pain
  • ECG findings are similar
  • Females often present w/ pain in back/shoulders
• Congestive Heart Failure

  • Younger counterparts present w/ SOB
  • Older pts often present w/ hypoxic sxs, lethargy, restlessness, and confusion
• GI Bleed

  • Mortality rate is ~1-%
  • Presentation is nonspecific and abdominal pain often absent
  • Altered mental status, syncope, dizziness
• Upper Respiratory Infection

  • In elderly, usually present w/ lethargy, confusion, anorexia
  • Might see decompensation in other conditions
  • More common s/sxs may be absent
  • Fever, chills, productive cough -- might not be seen!
• Urinary Tract Infection

  • Common
  • More common s/sxs may be absent
  • Dysuria, fever, flank pain
  • Often present w/ incontinence, confusion, abdominal pain, N/V, azotemia
  • New onset or worsening confusion/agitation?

  --> CHECK FOR UTI