Evaluation and Management of Chest Pain in the Elderly

Emerg Med Clin North Am. 2016 Aug;34(3):523-42. doi: 10.1016/j.emc.2016.04.006.

Abstract

Geriatric patients are at increased risk for serious morbidity and mortality from life-threatening causes of chest pain. This article covers 5 life-threatening causes of chest pain in the elderly: acute coronary syndrome, aortic dissection, pulmonary embolism, pneumothorax, and esophageal rupture. Atypical presentations, frailty, and significant comorbidities that characterize the elderly make the diagnosis and treatment of these already complicated conditions even more complicated. The emergency provider must be vigilant and maintain a low threshold to test. When a diagnosis is made, treatment must be aggressive. The elderly benefit from optimal care.

Keywords: Acute coronary syndrome; Aortic dissection; Chest pain; Elderly; Esophageal perforation; Geriatric; Pneumothorax; Pulmonary embolism.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / complications
  • Acute Coronary Syndrome / diagnosis
  • Acute Coronary Syndrome / therapy
  • Age Factors
  • Aged
  • Aortic Aneurysm / complications
  • Aortic Aneurysm / diagnosis
  • Aortic Aneurysm / therapy
  • Aortic Dissection / complications
  • Aortic Dissection / diagnosis
  • Aortic Dissection / therapy
  • Chest Pain / diagnosis*
  • Chest Pain / etiology
  • Chest Pain / therapy
  • Emergency Service, Hospital
  • Esophageal Perforation / complications
  • Esophageal Perforation / diagnosis
  • Esophageal Perforation / therapy
  • Humans
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / therapy