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Vasovagal syncope in the older person: differences in presentation between older and younger patients

Lookup NU author(s): Dr Gordon Duncan, Dr Maw Tan, Professor Julia Newton, Dr Steve Parry

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Abstract

Methods: 1,060 consecutive patients with tilt-positive VVS were identified from a prospective database containing the demographic and clinical information of individuals assessed in our unit over a 10-year period. VVS was diagnosed with appropriate haemodynamic changes during HUTT and accompanying symptom reproduction. Results: 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, 95% confidence interval (CI) = 0.38-0.64], near loss of consciousness (OR 0.53, 95% CI = 0.40-0.70) or palpitations (OR 0.45, 95% CI = 0.28-0.72) and more likely to present with unexplained falls (OR 2.33, 95% CI = 1.36-4.32). The typical provoking factors of prolonged standing (OR 0.55, 95% CI = 0.40-0.72), posture change (OR 0.61, 95% CI = 0.46-0.82) and hot environments (OR 0.57, 95% CI = 0.42-0.78) were also less common in older patients. Conclusion: 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.


Publication metadata

Author(s): Duncan GW, Tan MP, Newton JL, Reeve P, Parry SW

Publication type: Article

Publication status: Published

Journal: Age and Ageing

Year: 2010

Volume: 39

Issue: 4

Pages: 465-470

Print publication date: 05/05/2010

ISSN (print): 0002-0729

ISSN (electronic): 1468-2834

Publisher: Oxford University Press

URL: http://dx.doi.org/10.1093/ageing/afq039

DOI: 10.1093/ageing/afq039


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