Cardiovascular care in the older adult: Syncope
Date Published:
17 June 2020
Last updated:
17 June 2020 This resource series, curated by the BGS Cardiovascular SIG, brings together key principles and guidelines on the management of cardiovascular disease in older adults.
Syncope accounts for 1-8% of hospital admissions and incidence increases with age. Patients can present to a variety of different settings and assessment may involve Acute Medicine, Cardiology, Neurology and of course Medicine for the Elderly.
Diagnosis is based on the history and subsequent risk stratification – this will dictate further investigation and management. For complex patients, a specialist service is key to this, and a cross-specialty multidisciplinary team (MDT) with interested colleagues can be invaluable.
Below are some key guidelines and seminal papers on syncope and a blog about the benefits of multidisciplinary involvement.
Key guidelines
- Transient loss of consciousness (TLOC) in over-16s: clinical guideline [CG109] - National Institute for Health and Care Excellent (NICE)
This guideline aims to define the appropriate pathways for the initial assessment, diagnosis and specialist referral of people who have had TLOC, so that they receive the correct diagnosis quickly, efficiently and cost effectively, leading to a suitable management plan.
- Guidelines on Diagnosis and Management of Syncope - European Society of Cardiology
ESC Clinical Practice Guidelines on the diagnosis and management of syncope.
- Syncope Unit: rationale and requirement – the European Heart Rhythm Association position statement endorsed by the Heart Rhythm Society - EP Europace
Evidence for systems in secondary care for managing syncope.
- Neurological disorders: assessing fitness to drive - DVLA
Guide on driving implications for those with TLOC.
Recommended reading
Reviews of syncope in the older patient: