An Approach to Cardiac Syncope in the Elderly Patient

AbstractPurpose of ReviewSyncope in the geriatric population remains a considerable diagnostic challenge due to its often atypical presentation and multifactorial etiology. This is compounded by the rising incidence of coexisting medical conditions, frailty, and polypharmacy in this population. Patients who have a history of cardiovascular disease or whose presentations have historical factors suggestive of a cardiac etiology should undergo evaluation for potential cardiac causes of syncope. Here we outline a framework for the evaluation of cardiac syncope in the elderly patient.Recent FindingsAssessment should include eliciting a detailed history from the patient and available witnesses, confirming a complete medication list, performing a focused physical exam, and obtaining a 12-lead electrocardiogram. Special attention should be paid to signs of orthostatic hypotension, carotid disease, volume overload, valvular disease, cardiac ischemia, and any new arrhythmia.SummaryAn initial diagnostic framework of comprehensive history-taking, focused examination and early electrocardiography allows for timely triaging and targeted management of syncope while also providing flexibility to guide further diagnostic evaluation, which may include ischemic evaluation, echocardiography, advanced cardiac imaging, and ambulatory cardiac rhythm monitoring.
Source: Current Geriatrics Reports - Category: Geriatrics Source Type: research