How the systematic detection of delirium may help physicians avoid a misdiagnosis of acute myocardial infarction: Two case reports

A 93-year-old female and an 81-year-old female presented to the Emergency Department (ED) with hypoactive delirium. In both cases, a quite common delirium-precipitating factor was initially thought to be found by the ED physicians. However, a proactive searching for all medical reasons potentially underlying delirium enabled the physicians of our Acute Geriatric Unit to unveil a diagnosis of acute myocardial infarction. These cases illustrate the complexity of detecting delirium and its etiology, especially in frail patients. We suggest that a systematic diagnostic workup should be performed in all patients presenting with delirium, including an EKG and enzymes measurement even in the absence of typical cardiovascular symptoms.