MANAGEMENT OF SYNCOPE IN THE ELDERLY

WOS: 000282657400012Syncope in elderly patients is a clinical syndrome frequently observed both in emergency rooms and outpatient clinics and it may cause mortality depending on the etiology. The main pathology at the background is global cerebral hypoperfusion. Although syncope may be seen at all age groups, it is more common in older ages. Age-associated changes in various physiological parameters contribute to development of syncope in the elderly and the underlying etiology determines its prognosis. Among the many types of syncope in the elderly, cardiac syncope is the primary syndrome resulting in increased mortality. Therefore, identification of the etiology is very important in the management of syncope. When detailed anamnesis, physical examination and EKG are inadequate for the diagnosis of an elderly syncope patient, further invasive or noninvasive examination should be performed. In the case of syncope related to neural pathways, nonpharmacological approaches are preferred. Physicians should evaluate all the medications the patient is using and the withdrawal or reduction of culprit medication should be considered. Patients must be informed about the reasons and triggers of syncope. Patients with cardiac syncope require specific treatment and an implantable cardiac defibrillator (ICD) may be life saving for appropriate indications. Syncope in the elderly is an important geriatric syndrome that requires comprehensive assessment, rapid diagnosis and treatment