From the district Haarlem-Noord, 558 patients suffering from an acute myocardial infarction (AMI) were admitted in the years 1982 through 1985. Of these patients 62.9% was 65 years or older, 63.6% was male. The chance of getting an AMI was 8 times greater for the elderly than for younger people, which is in agreement with figures in the whole country. The most important feature--precordial pain--was less frequent in the elderly, i.e. 63.8% compared to 87% for younger people. However, the elderly suffered more from less specific symptoms as breathlessness, heartfailure, dizziness, syncope, neurological and psychiatric symptoms. The frequency of these symptoms varied from 4.5 to 30%. This is 2 to 5 times higher than for people younger than 65 years old. The mortality rate was 31% for people older than 65 years. This was significantly higher than the rate for younger patients (7.7%).