- Section 1 Ageing population and policy
- Section 2 Key concepts in care of older adults
- Section 3 Principles and organization of care
- Section 4 Age-related biological changes, altered physiology, and vulnerability to diseases and chronic conditions
- Section 5 Geriatric syndromes in clinical practice
- Section 6 Nutrition and metabolism
- Section 7 Mobility disorders: prevention, impact, and compensation
- Section 8 Infections in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 9 Cancer: epidemiology, pathophysiology, diagnosis, and management
- Section 10 Vascular diseases: epidemiology, pathophysiology, diagnosis, and management
- Chapter 95 Cardiac and vascular ageing
- Chapter 96 Dyslipidemias and other cardiometabolic risk factors in older adults
- Chapter 97 Physical factors in arterial ageing
- Chapter 98 Peripheral vascular disease in older adults: diagnostic and treatment considerations
- Chapter 99 Aneurysmal diseases
- Chapter 100 Pulmonary thromboembolism
- Chapter 101 Hypertension in older adults
- Chapter 102 Syncope and neurocardiovascular instability
- Chapter 103 Management of atrial fibrillation and anticoagulant therapies
- Chapter 104 Management of bradyarrhythmias
- Chapter 105 Management of tachyarrhythmias
- Chapter 106 Ischaemic heart disease
- Chapter 107 Valvular heart disease: state of the art and treatment perspectives
- Chapter 108 Heart failure: definitions, investigation, and management
- Chapter 109 Cardiac rehabilitation
- Chapter 110 Cardiopulmonary resuscitation: outcomes and decision-making processes for older adults
- Section 11 Neurological disorders: epidemiology, pathophysiology, diagnosis, and management
- Section 12 Cognitive decline and dementia in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 13 Mental health of older adults
- Section 14 Management of common medical conditions: epidemiology, pathophysiology, diagnosis, and management
- Section 15 Palliative medicine and end-of-life care
- Section 16 Healthy ageing
(p. 783) Syncope and neurocardiovascular instability
- Chapter:
- (p. 783) Syncope and neurocardiovascular instability
- Author(s):
Rose Anne Kenny
and Conal Cunningham
- DOI:
- 10.1093/med/9780198701590.003.0102
The prevalence of syncope rises with age and is challenging because of atypical presentation, overlap with falls, and poor recall of events. Cardiac causes and multiple comorbidities are more common, and related morbidity and mortality are higher than in younger patients. Hence, a high index of suspicion for cardiovascular causes of falls and dual pathology will increase successful diagnosis and intervention. Age-related neurohumoral and physiological changes plus chronic diseases and medications often contribute to syncope. Orthostatic hypotension, carotid sinus syndrome, vasovagal syncope, postprandial syncope, sinus node disease, atrioventricular block, and ventricular tachycardia are other common causes. Management is often based on removing or reducing the predisposing or precipitating factors through medication adjustments, behavioural strategies, and more invasive cardiac interventions if indicated. It is often not possible to identify a single cause of syncope in older persons, hence apragmatic management of each diagnosis is recommended.
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- Section 1 Ageing population and policy
- Section 2 Key concepts in care of older adults
- Section 3 Principles and organization of care
- Section 4 Age-related biological changes, altered physiology, and vulnerability to diseases and chronic conditions
- Section 5 Geriatric syndromes in clinical practice
- Section 6 Nutrition and metabolism
- Section 7 Mobility disorders: prevention, impact, and compensation
- Section 8 Infections in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 9 Cancer: epidemiology, pathophysiology, diagnosis, and management
- Section 10 Vascular diseases: epidemiology, pathophysiology, diagnosis, and management
- Chapter 95 Cardiac and vascular ageing
- Chapter 96 Dyslipidemias and other cardiometabolic risk factors in older adults
- Chapter 97 Physical factors in arterial ageing
- Chapter 98 Peripheral vascular disease in older adults: diagnostic and treatment considerations
- Chapter 99 Aneurysmal diseases
- Chapter 100 Pulmonary thromboembolism
- Chapter 101 Hypertension in older adults
- Chapter 102 Syncope and neurocardiovascular instability
- Chapter 103 Management of atrial fibrillation and anticoagulant therapies
- Chapter 104 Management of bradyarrhythmias
- Chapter 105 Management of tachyarrhythmias
- Chapter 106 Ischaemic heart disease
- Chapter 107 Valvular heart disease: state of the art and treatment perspectives
- Chapter 108 Heart failure: definitions, investigation, and management
- Chapter 109 Cardiac rehabilitation
- Chapter 110 Cardiopulmonary resuscitation: outcomes and decision-making processes for older adults
- Section 11 Neurological disorders: epidemiology, pathophysiology, diagnosis, and management
- Section 12 Cognitive decline and dementia in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 13 Mental health of older adults
- Section 14 Management of common medical conditions: epidemiology, pathophysiology, diagnosis, and management
- Section 15 Palliative medicine and end-of-life care
- Section 16 Healthy ageing