Document Detail

Syncope. Identifying cardiac causes in older patients.
MedLine Citation:
PMID:  12756678     Owner:  NLM     Status:  MEDLINE    
Syncope is a transient loss of consciousness and postural tone, with spontaneous recovery, and may represent an episode of aborted cardiac arrest. The final common pathway for loss of consciousness from non-neurologic causes is hypoperfusion of the reticular activating system. The etiology of syncope in older patients frequently includes a myriad of causes (e.g., orthostatic hypotension, medication side effects, sick sinus syndrome, atrioventricular block, carotid hypersensitivity, ventricular tachycardia, and aortic stenosis). Initial evaluation must include a detailed history, complete physical examination, and 12-lead ECG, which provides a framework as to the probable cause of syncope in approximately 40% of patients. Echocardiography, electrophysiology testing, and head-upright tilt table testing will confirm the diagnosis in most of the remainder. Approximately 25% of patients will have no identifiable cause of syncope, but have a better prognosis than patients with a confirmed cardiac cause of syncope. Treatment is directed at the underlying cause.
Behzad B Pavri; Reginald T Ho
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Geriatrics     Volume:  58     ISSN:  0016-867X     ISO Abbreviation:  Geriatrics     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-21     Completed Date:  2003-06-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985102R     Medline TA:  Geriatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  26-31; quiz 32     Citation Subset:  AIM; IM    
Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, USA.
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MeSH Terms
Cardiovascular Diseases / complications,  diagnosis*
Diagnostic Techniques, Cardiovascular*
Geriatric Assessment
Medical History Taking
Syncope / etiology*,  therapy
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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