This paper addresses disparities in reperfusion therapy, particularly primary percutaneous coronary interventions (PCI), for elderly patients experiencing acute myocardial infarction (AMI). Despite proven benefits, our center’s data reveals a stark contrast in PCI rates between younger and older patients, leading to significantly higher mortality among the elderly. Rooted in concerns about comorbidities, the reluctance to administer PCI prompts ethical questions 
and necessitates a critical examination of age-based clinical decision-making. The paper advocates for optimized AMI management protocols, emphasizing an individualized approach and evidence-based guidelines. Recognizing challenges in accurate AMI diagnosis in the elderly, educational initiatives target healthcare professionals and the population, disseminating information about symptoms and treatment benefits. To combat age-related stereotypes, 
digital tools like virtual consultations and telemedicine enhance accessibility to information. The paper proposes policy initiatives prioritizing clinical condition over age in treatment decisions, ensuring equitable care. In conclusion, urgent action is required to bridge the gap in reperfusion therapy for elderly AMI patients. By fostering inclusivity, implementing education, and advocating policy changes, we aim to ensure every patient, irrespective of age, receives 
timely and appropriate life-saving interventions.

Introduction. Patients with acute myocardial infarction should be treated with early revascularization. Patients over 73
years have a higher risk of infarct-related cardiogenic shock, which is a leading cause of lethality. Unfortunately, little
is known about myocardial revascularization care for elderly people in Ukraine. We presented a 92-year-old lady with
an acute chest pain case report, which was not revealed by analgesics.
Important clinical findings. Coronary angiography revealed thrombotic occlusion of the distal segment of the left anterior descending artery (LAD) and floated thrombus in LAD mid-segment; stenosis of the left circumflex artery (LCx) close to the first obtuse marginal artery (OM1).
The main diagnosis. Acute myocardial infarction with ST-segment elevation of the left ventricle anterior wall (anteriorSTEMI). Calcific aortic valve disease, severe aortic valve stenosis, significant mitral and tricuspid valve regurgitation,
pulmonary hypertension. Heart failure with reduced LVEF (<40%), NYHA class III symptoms.
Intervention. The decision was to perform urgent stenting in LAD and balloon angioplasty in LCx. Successful hospital discharge was after 14 days.
Conclusions. Take-away lessons: Elderly patients with acute myocardial infarction can be successfully treated in Ukraine. Age and comorbidities are not a contraindication for early myocardial revascularization.