| Syncope in the elderly. | |
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MedLine Citation:
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PMID: 12616401 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Syncope is defined as a self-limited loss of consciousness, usually combined with falling due to the inability to maintain postural tone. The underlying mechanism is a transient global cerebral hypoperfusion. The aetiology essentially includes cardiac disorders (structured heart disease or arrhythmias), neurally-mediated reflex syndromes, orthostatic hypotension and carotid sinus syndrome. History and physical examination will lead to the diagnosis in up to 50%. The most important step is to differentiate patients with heart disease from others, since the mortality of these patients is doubled. Echocardiography, Holter-monitoring and electrophysiological study are useful to approach this population. In patients with suspected neurally-mediated syncope (vasovagal syncope) tilt testing is indicated. Treatment depends on the aetiology. The diagnostic work-up and the therapeutic approach of patients with syncope are outlined. For patients with vasovagal syncope conventional therapeutic strategies include an increased salt/fluid intake, moderate exercise training, tilt-sleeping or tilt-training. Beta-blockers failed to show efficacy in a number of randomised trials. Recently, pacemaker implantation in selected patients with recurrent vasovagal syncopical episodes showed a significant increase in syncope-free survival, compared to no therapy and compared to beta-blocker therapy. In contrast to the increased mortality risk for patients with cardiac syncope, patients with vasovagal syncope have a benign prognosis. |
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Authors:
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J Wöhrle; M Kochs |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Zeitschrift für Gerontologie und Geriatrie Volume: 36 ISSN: 0948-6704 ISO Abbreviation: Z Gerontol Geriatr Publication Date: 2003 Feb |
Date Detail:
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Created Date: 2003-03-04 Completed Date: 2003-08-05 Revised Date: 2011-08-18 |
Medline Journal Info:
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Nlm Unique ID: 9506215 Medline TA: Z Gerontol Geriatr Country: Germany |
Other Details:
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Languages: eng Pagination: 2-9 Citation Subset: IM |
Affiliation:
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Department of Cardiology, University of Ulm, Robert-Koch-Strasse 8, 89081 Ulm, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Accidental Falls
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prevention & control* Aged Diagnosis, Differential Electrocardiography Humans Ischemic Attack, Transient / etiology, prevention & control Risk Factors Syncope / etiology*, prevention & control Tilt-Table Test |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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