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The Diagnosis of Syncope in the Elderly

Published online by Cambridge University Press:  10 March 2009

Howard S. Frazier
Affiliation:
Harvard School of Public Health

Abstract

Given a group of individuals presenting with syncope, the use of the standard diagnostic maneuvers will yield a diagnosis for approximately half. Promising new diagnostic tests offer the prospect of more efficient diagnostic pathways and treatments and demonstrate the need for better clinical trials before they are adopted.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1993

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References

REFERENCES

1.Adams, M. E., Antczak-Bouckoms, A., Frazier, H. S., et al. Assessing the effectiveness of ambulatory cardiac monitoring for specific clinical indications: Introduction. International Journal of Technology Assessment in Health Care, 1992, 9, 97101.CrossRefGoogle Scholar
2.Bass, E. B., Curtis, E. I., Arena, V. C., et al. The duration of Holter monitoring in patients with syncope: Is 24 hours enough? Archives of Internal Medicine, 1990, 150, 1073–78.CrossRefGoogle Scholar
3.Ben-Chetrit, E., Flugelman, M., & Eliakim, M.Syncope: A retrospective study of 101 hospitalized patients. Israel Journal of Medical Science, 1985, 21, 950–53.Google ScholarPubMed
4.Clark, P. I., Glasser, S. P., & Spoto, E. Jr., Arrhythmias detected by ambulatory monitoring. Lack of correlation with symptoms of dizziness and syncope. Chest, 1980, 77, 722–25.CrossRefGoogle ScholarPubMed
5.Coplen, S. E., Antman, E. M., Berlin, J. A., et al. Efficacy and safety of quinidine therapy for maintenance of sinus rhythm after cardioversion. A meta-analysis of randomized control trials. Circulation, 1990, 82, 1106–16.CrossRefGoogle ScholarPubMed
6.Cumbee, S. R., Pryor, R. E., & Linzer, M.Cardiac loop ECG recording: A new noninvasive diagnostic test in recurrent syncope. Southern Medical Journal, 1990, 83, 3943.CrossRefGoogle ScholarPubMed
7.Day, S. C., Cook, E. F., Funkenstein, H., & Goldman, L.Evaluation and outcome of emergency room patients with transient loss of consciousness. American Journal of Medicine, 1982, 73, 1523.CrossRefGoogle ScholarPubMed
8.Eagle, K. A., Black, H. R., Cook, E. F., & Goldman, L.Evaluation of prognostic classifications for patients with syncope. American Journal of Medicine, 1985, 79, 455–60.CrossRefGoogle ScholarPubMed
9.Gibson, T. C., & Heitzman, M. R.Diagnostic efficacy of 24-hour electrocardiographic monitoring for syncope. American Journal of Cardiology, 1984, 53, 1013–17.CrossRefGoogle ScholarPubMed
10.Glasser, S. P., Clark, P. I., & Applebaum, H. J.Occurrence of frequent complex arrhythmias detected by ambulatory monitoring. Findings in an apparently healthy asymptomatic elderly population. Chest, 1979, 75, 565–68.CrossRefGoogle Scholar
11.Grubb, B. P., Temesy-Armos, P., Hahn, H., & Elliott, L.Utility of upright tilt-table testing in the evaluation and management of syncope of unknown origin. American Journal of Medicine, 1991, 90, 610.CrossRefGoogle ScholarPubMed
12.Handelsman, H.Public health service assessment: Real-time cardiac monitors, 1989. Healt Technology Assessment Reports, No. 4. Washington. DC: National Center for Health Services Research and Health Care Technology Assessment, U. S. Department of Health and Human Services, Public Health Service, 1989.Google Scholar
13.Hine, L. K., Laird, N., Hewitt, P., & Chalmers, T. C.Meta-analytic evidence against prophylactic use of lidocaine in acute myocardial infarction. Archives of Internal Medicine, 1989, 149, 2694–98.CrossRefGoogle ScholarPubMed
14.Kapoor, W. N.Evaluation of syncope in the elderly. Journal of the American Geriatric Society, 1987, 35, 826–28.CrossRefGoogle ScholarPubMed
15.Kapoor, W. N.Evaluation and outcome of patients with syncope. Medicine, 1990, 69,160–75.CrossRefGoogle ScholarPubMed
16.Kapoor, W. N.Diagnostic evaluation of syncope. American Journal of Medicine, 1991, 90, 91106.CrossRefGoogle ScholarPubMed
17.Kapoor, W. N., Cha, R., Peterson, J. R., & Wieand, H. S.Prolonged electrocardiographic monitoring in patients with syncope. Importance of frequent or repetitive ventricular ectopy. American Journal of Medicine, 1987, 82, 2028.CrossRefGoogle ScholarPubMed
18.Kapoor, W. N., Hammill, S. C, & Gersh, B. J.Diagnosis and natural history of syncope and the role of invasive electrophysiolgic testing. American Journal of Cardiology, 1989, 63, 731–34.CrossRefGoogle Scholar
19.Kapoor, W. N., Karpf, M., Maher, Y., et al. Syncope of unknown origin. The need for a more cost-effective approach to its diagnostic evaluation. Journal of the American Medical Association, 1982, 247, 2687–91.CrossRefGoogle Scholar
20.Kapoor, W. N., Karpf, M., Wieand, S., et al. A prospective evaluation and follow-up of patients with syncope. New England Journal of Medicine, 1983, 309, 197204.CrossRefGoogle ScholarPubMed
21.Kapoor, W., Snustad, D., Peterson, J., et al. Syncope in the elderly. American Journal of Medicine, 1986, 80, 419–28.CrossRefGoogle ScholarPubMed
22.Kligfield, P., Stein, K. M., & Herrold, E. M.Computer-assisted analysis of Holter recordings. Annals of the New York Academy of Sciences, 1990, 601, 353–69.CrossRefGoogle ScholarPubMed
23.Kostis, J. B., McCrone, K., Moreyra, A. E., et al. The effect of age, blood pressure and gender on the incidence of premature ventricular contractions. Angiology, 1982, 07, 464–73.CrossRefGoogle ScholarPubMed
24.Kushner, J., Kou, W., Kadish, A., & Morady, F.Natural history of patients with unexplained syncope and a nondiagnostic electrophysiologic study. Journal of the American College of Cardiology, 1989, 14, 391–96.CrossRefGoogle Scholar
25.Linzer, M.Syncope: 1991. American Journal of Medicine, 1991, 90, 15.CrossRefGoogle ScholarPubMed
26.Lipsitz, L. A., Pluchino, F. C, Wei, J. Y., & Rowe, J. W.Syncope in institutionalized elderly: The impact of multiple pathological conditions and situational stress. Journal of Chronic Diseases, 1986, 39, 619–30.CrossRefGoogle ScholarPubMed
27.Lipsitz, L. A., Wei, J. Y., & Rowe, J. W.Syncope in an elderly institutionalized population: Prevalence, incidence and associated risk. Quarterly Journal of Medicine (New Series), 1985, 55, 4554.Google Scholar
28.Manolis, A. S., Linzer, M., Salem, D., & Estes, N. A. M. III. Syncope: Current diagnostic evaluation and management. Annals of Internal Medicine, 1990, 112, 850–63.CrossRefGoogle ScholarPubMed
29.Mond, H. G.The bradyarrhythmias: Current indications for permanent pacing, parts I and II. PACE, 1981, 4, 432–42, 538–47.CrossRefGoogle Scholar
30.Moss, A. J.Classifying and evaluating syncope. Geriatrics, 1978, 33, 103–14.Google ScholarPubMed
31.National Center for Health Statistics. Vital statistics of the U.S., 1987, vol. 2, sec. 6: Life tables. Washington, DC: Public Health Service, 1990.Google Scholar
32.Strasberg, B., Sagie, A., Rechavia, E., et al. The noninvasive evaluation of syncope of suspected cardiovascular origin. American Heart Journal, 1989, 117, 160–63.CrossRefGoogle ScholarPubMed