Vasovagal syncope (VVS) is increasingly being diagnosed in geriatric patients. These British researchers sought to examine the clinical features of VVS in different age groups. Patients (n=1,060) with VVS diagnosed by positive head-up tilt table test (HUTT) were identified from a prospective database.
The authors report: "we found a bimodal age distribution with a small peak at 20-29 years and a larger peak at 70-79 years. Patients aged 60 years were less likely to report total loss of consciousness (odds ratio (OR) 0.50), near loss of consciousness (OR 0.53) or palpitations (OR 0.45) and more likely to present with unexplained falls (OR 2.33). The typical provoking factors of prolonged standing (OR 0.55), posture change (OR 0.61) and hot environments (OR 0.57) were also less common in older patients."
The authors concluded: "in our large study population, VVS was more common in older patients. The clinical presentation differed significantly between the two groups. Older patients were less likely to give a typical history and therefore clinicians need to have a high index of suspicion when evaluating the older patient presenting with collapse or unexplained falls."
This study identifies important differences is presentation of vasovagal syncope in geriatric patients, and is a reminder to be on the lookout for the diagnosis in this population.
For the full abstract, click here.
Age and Ageing 39(4):465-470, July 2010 © The Author 2010
Vasovagal syncope in the older person: differences in presentation between older and younger patients. Gordon W. Duncan, Maw Pin Tan, Julia L. Newton, Pamela Reeve and Steve W. Parry. Correspondence to S W Parry: steve.parry@nuth.nhs.uk
Category: N. Neurological. Keywords: vasovagal syncope, tilt-table test, unexplained falls, elderly, geriatric, epidemiologic study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 23 July 2010
