Browse by author
Lookup NU author(s): Dr Liesl Allcock
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
Background. Dizziness, syncope, and falls are common occurrences in elderly people. Neurocardiovascular investigation units aim to detect those patients who fall due to disturbances of blood pressure control or cardiac conduction. Specialist units have a high diagnostic yield in the investigation of these problems. Dues this translate to less specialized centers? We report on the diagnostic findings of a district general hospital neurocardiovascular investigation unit. Methods. A total of 120 consecutive patients over the age of 65 presenting to a single geriatrician a ere assessed. After a full history and physical examination, patients underwent neurocardiovascular investigation: blood pressure and heart rate response to active stand, carotid sinus massage, and 30-minute head-up tilt. Results. The 120 patients assessed had a mean age of 78 years (range 66-94 years); in this group, 85 were women. Of these patients, 23% presented with falls, 14% with blackouts, and 30% with dizziness. The remaining 33% had overlap of symptoms. Neurocardiovascular investigations produced a diagnosis in 57% of the patients: 22% had cardioinhibitory carotid sinus syndrome (CSS); 15% had vasodepressor CSS; 29% had orthostatic hypotension: and 3% had vasovagal syncope. Thirteen percent had more than one neurocardiovascular abnormality and 18% had benign positional vertigo. Five patients had postural instability causing falls. Hyperventilation syndrome, aortic stenosis, dysrhythmia, cervical spondylosis, and epilepsy each accounted for one case. Seventeen percent of the subjects remained undiagnosed after integrated neurocardiovascular assessment. Conclusion. Management of falls requires access to neurocardiovascular assessment. It is feasible to provide such a service in the district general hospital setting, with a comparable diagnostic yield to tertiary referral centers.
Author(s): Allcock LM, O'Shea D
Publication type: Article
Publication status: Published
Journal: Journals of Gerontology: Series A - Biological Sciences and Medical Sciences
Year: 2000
Volume: 55
Issue: 8
Pages: M458-M462
ISSN (print): 1079-5006
ISSN (electronic): 1758-535X
Publisher: Oxford University Press
URL: http://dx.doi.org/10.1093/gerona/55.8.M458
DOI: 10.1093/gerona/55.8.M458
PubMed id: 10952369
Altmetrics provided by Altmetric