Abstract

ASENSIO-LAFUENTE, Enrique et al. Syncope in the elderly: Findings of diagnostic complementary tests in an University Hospital. Arch. Cardiol. Méx. [online]. 2009, vol.79, n.3, pp.201-206. ISSN 1665-1731.

Syncope is a common symptom among older adults. Its aetiologic diagnosis is mainly clinical, but when it has an unknown origin, complementary studies are necessary. We present the experience of a single center in diagnosing Unknown Origin Syncope (UOS). Methods: We performed a transversal retrolective study to assess the different tests done to patients studied because of USO. Results: The mean age of the older group was 77.6±6.9 years. The 24-hour Holter were abnormal in 77.9% of patients, but diagnostic in only 16.3%. Age older than 65 years was associated with a 1.9 increase (Cl 95% 0.9 - 4) in the possibilities of having a diagnosis, while age lesser than 65 was associated with a 0.5 risk IC 95% 0.2 - 1.08 of having a diagnosis. The 48-hour holter showed similar results. Older age was associated with a 1.69 OR, Cl 95% 0.6 - 4.4 to have a positive Tilt test (91% of older patients). They had mainly the vasodepressor variety of neurally-mediated syncope. (57.1% Vs 40.1%, p =0.01). Of the 6 electrophysiologic studies performed in people older than 65 years, 3 where diagnostic (50% Vs 33.3%, p =0.6). Conclusions: Complimentary tests in people elder than 65 years are diagnostic in a higher proportion than in their younger counterparts. Nevertheless there is a higher risk of false-positive results, so tests such as head-up tilt test should be more carefully interpreted.

Keywords : Syncope in the elderly; Diagnosis; Holter; Head-up tilt test; Electrophysiologic study.

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