Electrocardiographic and Echocardiographic Differences between Very Young and Older Adults with First Acute Myocardial Infarction

Background: Acute myocardial infarction (AMI) traditionally affects older adults, but recent trends show increasing prevalence in very young adults. This shift requires comparing diagnostic features across age groups. This study compares electrocardiographic and echocardiographic differences between very young (≤30 years) and older adults (≥50 years) with first acute myocardial infarction. Methods: This cross-sectional study was conducted in tertiary hospitals in Dhaka, Bangladesh, including the Department of Cardiology at Dhaka Medical College & Hospital, Sir Salimullah Medical College & Mitford Hospital, National Institute of Cardiovascular Diseases (NICVD), and Bangladesh Specialized Hospital (BSH) from July 2022 to December 2023. The study enrolled 160 first AMI patients divided into Group I (≤30 years) and Group II (≥50 years), each with 80 patients. Data collection included structured interviews, clinical evaluation, ECG, and echocardiographic assessments. Statistical analysis used SPSS v26.0, with significance at p<0.05. Results: STEMI was more common in very young adults (61.3% vs. 46.3%), while anterior infarction was more frequent among older patients (18.8% vs. 5.0%, p=0.007). Median LVEF was higher in Group I (47%) than Group II (43%, p=0.046), showing better preserved LV function. However, older patients had "good" systolic function (EF ≥50%). Ventricular fibrillation occurred only in the younger group, while complete heart block was more frequent among them. Most ECG and arrhythmic complications showed no significant age-related differences. Conclusion: This study reveals age-related differences in ECG and echocardiographic profiles among AMI patients, emphasizing the need for age-adapted diagnostic and management strategies.