Background: Recognizing the symptoms of acute coronary syndrome, as a leading cause of death among the elderly, is important for performing a successful intervention .This study aimed to predict the acute coronary syndrome based on the typical and atypical symptoms reported in the patients above and below 65 years.

Materials and Methods: In this cross-sectional study, 446 patients with acute coronary syndrome were randomly selected among the cardiac intensive care units of 8 hospitals in Tehran. Data were collected using a checklist consisting of the symptoms of acute coronary syndrome.

Results: Results showed that there was a statistically significant difference in the typical symptoms between the two age groups (above and below 65 years). The most typical symptom reported in patients above 65 years was dyspnea and the least one jaw or neck pain. Moreover, the most atypical symptom in patients over 65 years was palpitation and the least symptoms in the right side of the chest and indigestion, respectively. Logistic regression analysis showed that after the inclusion of both typical and atypical symptoms and age variable in the model, the incidence of chest symptoms, arm pain, dyspnea and neck or jaw pain can be predicted in the two age groups.

Conclusion: The results of this study reveal that age, as a variable, can predict the most typical symptoms of acute coronary syndrome.