Syncope in the Older Person

Iain G Matthews; Isabel A E Tresham; Steve W Parry

doi:10.1016/j.ccl.2015.04.009

Syncope in the Older Person

Cardiol Clin. 2015 Aug;33(3):411-21. doi: 10.1016/j.ccl.2015.04.009.

Authors

Iain G Matthews¹, Isabel A E Tresham², Steve W Parry³

Affiliations

¹ Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne NE4 5PL, UK.
² Falls and Syncope Service, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
³ Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; Falls and Syncope Service, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK. Electronic address: steve.parry@nuth.nhs.uk.

PMID: 26115827
DOI: 10.1016/j.ccl.2015.04.009

Abstract

Syncope in the older person carries a high morbidity, mortality, and health economic burden. While neurally mediated disorders and orthostatic hypotension account for the majority of syncopal episodes in this age group, around a third of causes are cardiac, predominantly arrhythmic. Clinicians need to be aware of the management of potential comorbid issues such as osteoporosis and cognitive impairment and if not in a position to act on them, ensure that appropriate specialist help is sought. Further work is needed to understand the pathophysiology and hence the management of syncope in the older patient, with ongoing studies helping to tease out some of the treatment controversies.

Keywords: Arrhythmia; Falls; Neurally mediated disorders; Older people; Orthostatic hypotension; Syncope.

Publication types

Review

MeSH terms

Cardiac Pacing, Artificial / adverse effects*
Global Health
Humans
Hypotension, Orthostatic / complications*
Incidence
Risk Factors
Syncope* / diagnosis
Syncope* / epidemiology
Syncope* / etiology
Tilt-Table Test / methods*