Carbon monoxide toxicity in older adults

There is a scarcity of research that specifically examines acute carbon monoxide (CO) toxicity in the elderly, however, prevalence may be underestimated in this group. CO toxicity is associated with acute myocardial injury, which may lead to chest pain, myocardial infarction, arrhythmias, or congestive heart failure, and in cases of chronic exposure, neurologic damage is possible. The primary goal of treatment is prevention of neurocognitive sequelae. The presenting symptoms of CO toxicity can easily be misdiagnosed, with deleterious effects. Clinicians must maintain a high index of suspicion for CO toxicity in older adults who present with influenza-like symptoms, myocardial infarction, syncope, and mental status changes, particularly during the winter months. In this article, the authors present the case of an older adult presenting with signs of CO exposure after falling unconscious in his home immediately following his discharge from a prior hospitalization and rehabilitation for syncope.