Turkish Journal of Geriatrics 2010 , Vol 13 (Supplement)
SYNCOPE IN ELDERLY
Özgür ASLAN
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