Managing the Grandparent with Chest Pain: Advice for Emergency Pediatricians

Faced with a grandparent, really any older adult, complaining of chest pain, the emergency pediatrician is not required to have an in-depth knowledge of adult internal medicine to effectively perform an initial evaluation and commence investigation and treatment. The approach to these patients requires the recognition of chest pain as a potential hallmark of a life-threatening illness, including myocardial infarction. A standardized approach to any adult with chest pain should include the efficient delivery of basic diagnostic and therapeutic interventions that should be available even in a specialized pediatric institution. Timely transfer to an adult facility to complete the assessment and to exclude life-threatening causes is essential to maximize the outcome of these patients.