The changing face of orthostatic and neurocardiogenic syncope with age.

Hdl Handle:
http://hdl.handle.net/10147/206296
Title:
The changing face of orthostatic and neurocardiogenic syncope with age.
Authors:
Cooke, J; Carew, S; Costelloe, A; Sheehy, T; Quinn, C; Lyons, D
Affiliation:
Mid-Western Regional Hospital (Department of Medicine, Division of Ageing &, Therapeutics) & Graduate Entry Medical School, University of Limerick, Limerick, , Ireland. johnp.cooke@yahoo.com
Citation:
QJM. 2011 Aug;104(8):689-95. Epub 2011 Mar 7.
Journal:
QJM : monthly journal of the Association of Physicians
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206296
DOI:
10.1093/qjmed/hcr032
PubMed ID:
21382922
Abstract:
AIM: Reports of the outcomes of syncope assessment across a broad spectrum of ages in a single population are scarce. It is our objective to chart the varying prevalence of orthostatic and neurocardiogenic syncope (NCS) as a patient ages. METHODS: This was a retrospective study. All consecutive patients referred to a tertiary referral syncope unit over a decade were included. Patients were referred with recurrent falls or orthostatic intolerance. Tilt tests and carotid sinus massage (CSM) were performed in accordance with best practice guidelines. RESULTS: A total of 3002 patients were included (1451 short tilt, 127 active stand, 1042 CSM and 382 prolonged tilt). Ages ranged from 11 to 91 years with a median (IQR) of 75 (62-81) years. There were 1914 females; 1088 males. Orthostatic hypotension (OH) was the most commonly observed abnormality (test positivity of 60.3%). Those with OH had a median (IQR) age of 78 (71-83) years. Symptomatic patients were significantly younger than asymptomatic (P = 0.03). NCS demonstrated a bimodal age distribution. Of 194 patients with carotid sinus hypersensitivity, the median age (IQR) was 77 (68-82) years. Those with vasovagal syncope (n = 80) had a median (IQR) age of 30 (19-44) years. There were 57 patients with isolated postural orthostatic tachycardia syndrome. Of the total patients, 75% were female. They had a median (IQR) age of 23 (17-29) years. CONCLUSION: We have confirmed, in a single population, a changing pattern in the aetiology of syncope as a person ages. The burden of disease is greatest in the elderly.
Language:
eng
MeSH:
Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Aging/*pathology; Child; Cost of Illness; Female; Humans; Hypotension, Orthostatic/complications/diagnosis/*epidemiology; Male; Middle Aged; Posture/*physiology; Prevalence; Retrospective Studies; Syncope, Vasovagal/diagnosis/*epidemiology/etiology; Tilt-Table Test; Young Adult
ISSN:
1460-2393 (Electronic); 1460-2393 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorCooke, Jen_GB
dc.contributor.authorCarew, Sen_GB
dc.contributor.authorCostelloe, Aen_GB
dc.contributor.authorSheehy, Ten_GB
dc.contributor.authorQuinn, Cen_GB
dc.contributor.authorLyons, Den_GB
dc.date.accessioned2012-01-31T16:48:37Z-
dc.date.available2012-01-31T16:48:37Z-
dc.date.issued2012-01-31T16:48:37Z-
dc.identifier.citationQJM. 2011 Aug;104(8):689-95. Epub 2011 Mar 7.en_GB
dc.identifier.issn1460-2393 (Electronic)en_GB
dc.identifier.issn1460-2393 (Linking)en_GB
dc.identifier.pmid21382922en_GB
dc.identifier.doi10.1093/qjmed/hcr032en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206296-
dc.description.abstractAIM: Reports of the outcomes of syncope assessment across a broad spectrum of ages in a single population are scarce. It is our objective to chart the varying prevalence of orthostatic and neurocardiogenic syncope (NCS) as a patient ages. METHODS: This was a retrospective study. All consecutive patients referred to a tertiary referral syncope unit over a decade were included. Patients were referred with recurrent falls or orthostatic intolerance. Tilt tests and carotid sinus massage (CSM) were performed in accordance with best practice guidelines. RESULTS: A total of 3002 patients were included (1451 short tilt, 127 active stand, 1042 CSM and 382 prolonged tilt). Ages ranged from 11 to 91 years with a median (IQR) of 75 (62-81) years. There were 1914 females; 1088 males. Orthostatic hypotension (OH) was the most commonly observed abnormality (test positivity of 60.3%). Those with OH had a median (IQR) age of 78 (71-83) years. Symptomatic patients were significantly younger than asymptomatic (P = 0.03). NCS demonstrated a bimodal age distribution. Of 194 patients with carotid sinus hypersensitivity, the median age (IQR) was 77 (68-82) years. Those with vasovagal syncope (n = 80) had a median (IQR) age of 30 (19-44) years. There were 57 patients with isolated postural orthostatic tachycardia syndrome. Of the total patients, 75% were female. They had a median (IQR) age of 23 (17-29) years. CONCLUSION: We have confirmed, in a single population, a changing pattern in the aetiology of syncope as a person ages. The burden of disease is greatest in the elderly.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAge Factorsen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshAging/*pathologyen_GB
dc.subject.meshChilden_GB
dc.subject.meshCost of Illnessen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHypotension, Orthostatic/complications/diagnosis/*epidemiologyen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPosture/*physiologyen_GB
dc.subject.meshPrevalenceen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshSyncope, Vasovagal/diagnosis/*epidemiology/etiologyen_GB
dc.subject.meshTilt-Table Testen_GB
dc.subject.meshYoung Adulten_GB
dc.titleThe changing face of orthostatic and neurocardiogenic syncope with age.en_GB
dc.contributor.departmentMid-Western Regional Hospital (Department of Medicine, Division of Ageing &, Therapeutics) & Graduate Entry Medical School, University of Limerick, Limerick, , Ireland. johnp.cooke@yahoo.comen_GB
dc.identifier.journalQJM : monthly journal of the Association of Physiciansen_GB
dc.description.provinceMunster-
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