Purpose of Review <p>Cardiovascular disease (CVD) is common among older adult patients. With the growth of this demographic, it will be particularly important for emergency medicine providers to recognize key differences in the evaluation and management of geriatric patients with CVD.</p> Recent Findings <p>The identification and management of CVD can be challenging in the older adult patient. Many of the classically taught components of a history and physical exam that might suggest acute CVD may not be present in geriatric patients. Furthermore, chronic disease conditions as well as polypharmacy, commonly seen in older adults, can make diagnostic testing more difficult to interpret and delay the identification of time sensitivity CVD processes. Finally, although the emergency medicine provider is often problem identification focused with an eye toward curative treatment, the recurrent nature of many CVD conditions in older adults often necessitates a palliative approach. Although this can be challenging in the acute setting for emergency medicine providers who often have limited longitudinal perspective with any one patient, it remains important to consider.</p> Summary <p>The best care of the older adult patient with CVD requires the recognition of a unique presentation pattern, nuances associated with diagnostic testing as well as tailored treatment approaches. Considering these facts as well as the aging of our population, it is imperative that the emergency medicine provider be familiar with evaluation of the geriatric patient for CVD.</p>