Elderly patient with delirium after myocardial infarction.

Delirium is a transient global disorder of cognition. Almost any medical illness or medication can cause delirium. Here, we report a 71-year-old male who presented to the emergency department with a sudden change in mental status, which later resolved. An electrocardiogram was consistent with acute myocardial infarction. The patient later developed symptoms of delirium, and haloperidol was administered. The symptoms did not resolve, and risperidone was initiated instead. The patient subsequently became hypotensive, and treatment was again changed to olanzapine. He returned to full consciousness with olanzapine treatment. When the potential hypotensive effects of haloperidol and risperidone are taken into consideration, in patients with high cardiac risk, olanzapine may provide a better option for the treatment of delirium.