Turkish Journal of Geriatrics
2010 , Vol 13 (Supplement)
SYNCOPE IN ELDERLY
Dokuz Eyül Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, İZMİR
Syncope is defined as a transient-loss of consciousness due to transient
global cerebral hypoperfusion characterized by rapid onset, short duration,
and spontaneous complete recovery. Currently, syncope is classified into three
groups: syncope of reflex origin, syncope due to orthostatic hypotension and
cardiovascular syncope. Orthostatic hypotension, carotid sinus disease and cardiovascular
diesases are the majör causes of syncope in patients with advanced
ages. However, it may not be easy to determine the main cause of synopal
episodes in the elderley population since several casues are frequently present
alltogether patients and the reliability of medical history can be limitied in these
patients. Similar to all other cases with syncope, elderly people are initially evaluated
by a detailed medical history, physical examination and an ECG recording.
Following this initial evaluation consisting of carotid sinus massage and
orthostatic blood pressure measurement, a decision can be made whether the
episode is a true syncope, its etiology can be defined and whether the patient
has a risk for death and/or cardiovascular events. Etiology of the syncope can
be defined in almost 90% of the patients with older ages by a standard diagnostic
approach. If a diagnosis can not be made, additional tests like orthostatic
stres tests and ambulatory ECG recordings are used. Finally, in elderly patients
with syncopal episodes of a certain etiology, therapy mainly aims to prolong life
as well as to prevent the recurrences and physical injuries.
Keywords :
Eldely; Syncope