What causes chest pain, and weight loss in the elderly?

Question

Hello doctor,

My mother experienced severe chest pain, persistent coughing, significant weight loss (emaciation), and loss of appetite for the past two months. Over the last six days, her symptoms have improved.

Based on what is most accurate, fastest, and most affordable, what should I do next?
Please choose only one: TB (tuberculosis) test or chest X-ray, or do nothing for now; just give her nutritious food?
Also, what do you think is the most likely diagnosis?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

I will be direct: based on accuracy, speed, and cost, the best immediate step is a chest X-ray.

Why chest X-ray?

Fast: Done in minutes; results often available the same day.
Affordable: Cheaper than full tuberculosis diagnostic panels.
Informative: Can quickly detect signs of:
1. Pulmonary tuberculosis (cavities, infiltrates, consolidation).
2. Pneumonia.
3. Lung cancer.
4. Other serious lung conditions.

While TB (tuberculosis) specific tests (for example, sputum culture, GeneXpert PCR) are more definitive for tuberculosis, they are slower (can take days to weeks) and more costly in many settings.

“Do nothing and give food” is not safe, given her prior severe symptoms like chest pain, emaciation, and prolonged cough. These could indicate a serious illness that cannot be ignored, even if she feels temporarily better.

Tentative diagnosis:

Most likely: Pulmonary tuberculosis (TB) – due to chronic cough, weight loss, chest pain, and duration.

Other possibilities:

Lung cancer (especially if older and emaciated quickly).
Chronic pneumonia.
Post-infectious recovery (possible, but less certain without imaging).

Take her for a chest X-ray immediately.

If the result is abnormal or suspicious, follow up with a TB test and further evaluation.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.