Syncope is a common condition among older adults, as its prevalence increases with age, reaching almost 20% among adults older than 75 (Goyal & Maurer, 2016). It is defined as “a self-limited transient loss of consciousness and postural tone due to global cerebral hypoperfusion” (Goyal & Maurer, 2016, 380). In simpler words, syncope fainting due to the body’s overreaction to certain triggers. Pathophysiology of syncope can be summarized as an abrupt reduction of blood pressure due to stress on the autonomic nervous system that leads to a loss of consciousness (Centeno et al., 2018). The common symptoms of syncope are pale skin, lightheadedness, tunnel vision, nausea, yawning, and blurred vision (Centeno et al., 2018). During a syncope episode, dilated pupils, weak pulse, and abnormal movements are also common (Centeno et al., 2018). The common diagnostic procedures for the condition include electrocardiogram, echocardiogram, exercise stress test, and tilt table test.
The treatment plan may include both pharmacological and non-pharmacological approaches. Non-pharmacological treatment includes lifestyle alterations such as increasing fluid and salt intake and Physical Counter Maneuvers (PCMs) (Kenny & McNicholas, 2016). Older adults are also recommended to engage in tilt training or home orthostatic training (Kenny & McNicholas, 2016). Among pharmacological interventions, care providers should consider fludrocortisone, alpha agonists, beta-blockers, and anti-cholinergic medications (Kenny & McNicholas, 2016). The patients with syncope may also be referred for surgery to insert an electric pacemaker (Kenny & McNicholas, 2016). The patients will be recommended a follow-up visit in six months to assess the effectiveness of treatment.
Syncope is a common cause of emergency room visits, as it is a common cause of falling among older adults. An estimated 2-year mortality rate among elderly syncope patients is 25% (Goyal & Maurer, 2016). Syncope has a significant impact on annual healthcare finance expenditures in the US due to its high prevalence (Goyal & Maurer, 2016). It also may be a reason for the increased expenditures of patients on healthcare, as it often leads to an inpatient admission (Goyal & Maurer, 2016).
References
Centeno, E., Mayuga, K., Fouad-Taraz, F., Shoemaker, L., & Jaeger, F. (2018). Syncope. Cleveland Clinic: Center for Continuing Education. Web.
Goyal, P., & Maurer, M. (2016). Syncope in older adults. Journal of Geriatric Cardiology, 13(5), 380-386.
Kenny, R., & McNicholas, T. (2016). The management of vasovagal syncope. QJM, 109(12), 767-773.