Syncope in Older Adults

Question 1

Syncope Definition

Answer 1

Transient loss of conscioussness due to transient global cerebral hypoperfusion characterized by rapid onset, short duration, and spontaneous complete recovery

Question 2

Causes

Answer 2

PASSOUT

• Pressure (low)
• Arrhythmias
• Seizure
• Sugar (low)
• Output/oxygen (low)
• Unusual causes
• Transient ischaemic attack/stroke

Question 3

Assesment

Answer 3

• Details of collapse
• Eyewittness accounts
• medication history should include the time relationship with onset of syncope
• co-morbidites, physical frailty and locomotor disability
• cognitive status
• injury
• social circumstances
• assessment of the autonomic system (postural blood pressure) neurological and locomotor systems, including observation of gait and balance

Question 4

Investiagations

Answer 4

• lying and standing blood pressure
• ECG
• an implantable loop recorder
• carotid sinus massage if >40
• tilt testing if cardiac cause or orthostatic hypotension excluded
• twenty-four hour ambilatory BP recording may be helpful if instability of BP is suspected
• echocardiogram if known or suspected structural cardiac disease