Common Causes of Syncope in Older Persons

The likely cause of syncope in older people alters.

Vascular disease and ischaemic heart disease are more prevalent, so it is vital to exclude a serious cardiac cause for the syncope.

• All older people presenting with syncope or 'collapse' should have an ECG.
• A echocardiogram should be strongly considered to assess cardiac function and exclude significant valvular heart disease.
• A non-invasive assessment for myocardial ischaemia should be performed if there are symptoms suggesting ischaemic heart disease.

Arrhythmic syncope, particularly due to bradycardia is more common in the older person and may be indicated by sinus bradycardia or pauses on ECG or Holter monitorining or if there is evidence of significant conducting system disease on the ECG.

Vasovagal syncope, orthostatic hypotension, postprandial hypotension and carotid sinus hypersensitivity are common causes of syncope in older people.

 

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