Syncope in Older Adults

Maxime Lamarre-Cliche, MD, FRCPC, MSc, Institut de Recherches Cliniques de Montréal, Université de Montréal, Montréal, QC.

Syncope is a frequent cause for emergency consultation and hospital admission; it is also an indicator of reduced survival rate among older adults. The differential diagnosis may be large, but bradyarrhythmias, neurocardiogenic syncope, carotid hypersensitivity syndrome, and orthostatic hypotension are the more frequent causes. Good history-taking and physical examination usually orient the diagnosis and testing strategy. In working with older patients, great care must be taken in assessing comorbidities and concomitant medications as they can exacerbate syncopal symptoms. A multidisciplinary and dedicated approach to syncope increases the diagnostic yield and rapid management of patients.
Key words: syncope, orthostatic hypotension, arrhythmia, neurally mediated syncope.