Cardiovascular syncope is the most common cause of drop attacks in the elderly.
Drop attacks are defined as a sudden loss of postural tone without loss of consciousness. The mechanism is often unknown. This report examines findings in consecutive elderly patients with drop attacks referred to a dedicated "syncope and falls" center. Thirty-five patients were included. A diagnosis was established in 25 (71%); cardioinhibitory cartoid sinus syndrome (CSS) or mixed CSS in 15, vasodepressor CSS in 3, orthostatic hypotension in 5, vasovagal syncope in 1, and gait imbalance in 1. In 21%, more than one pathological diagnosis was present. In conclusion, absence of a history of syncope is unreliable in elderly patients, and these individuals should be routinely investigated for hemodynamic changes during carotid massage and standing.
Dey
A B
AB
Cardiovascular Investigation Unit, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom.
Stout
N R
NR
Kenny
R A
RA
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D017704:Baroreflex / Q000502:physiology*; D002346:Carotid Sinus / Q000503:physiopathology*; D005260:Female; D005684:Gait; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications; D008297:Male; D009069:Movement Disorders / Q000150:complications; D011187:Posture; D011312:Pressure; D013575:Syncope / Q000150:complications*; D019462:Syncope, Vasovagal / Q000150:complications; D013577:Syndrome