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Cardiovascular Assessment of Falls in Older People

Falls in older people can be caused by underlying cardiovascular disorders, either because of balance instability in persons with background gait and balance disorders, or because of amnesia for loss of consciousness during unwitnessed syncope. Pertinent investigations include a detailed history, 12...

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Detalles Bibliográficos
Autores principales: Tan, Maw Pin, Kenny, Rose Anne
Formato: Texto
Lenguaje:English
Publicado: Dove Medical Press 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682455/
https://www.ncbi.nlm.nih.gov/pubmed/18047258
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author Tan, Maw Pin
Kenny, Rose Anne
author_facet Tan, Maw Pin
Kenny, Rose Anne
author_sort Tan, Maw Pin
collection PubMed
description Falls in older people can be caused by underlying cardiovascular disorders, either because of balance instability in persons with background gait and balance disorders, or because of amnesia for loss of consciousness during unwitnessed syncope. Pertinent investigations include a detailed history, 12-lead electrocardiography, lying and standing blood pressure, carotid sinus massage (CSM), head-up tilt, cardiac electrophysiological tests, and ambulatory blood pressure and heart rate monitoring, which includes external and internal cardiac monitoring. The presence of structural heart disease predicts an underlying cardiac cause. Conversely, the absence of either indicates that neurally mediated etiology is likely. CSM and tilt-table testing should be considered in patients with unexplained and recurrent falls. Holter monitoring over 24 hours has a low diagnostic yield. Early use of an implantable loop recorder may be more cost-effective. A dedicated investigation unit increases the likelihood of achieving positive diagnoses and significantly reduces hospital stay and health expenditure.
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spelling pubmed-26824552009-06-16 Cardiovascular Assessment of Falls in Older People Tan, Maw Pin Kenny, Rose Anne Clin Interv Aging Review Falls in older people can be caused by underlying cardiovascular disorders, either because of balance instability in persons with background gait and balance disorders, or because of amnesia for loss of consciousness during unwitnessed syncope. Pertinent investigations include a detailed history, 12-lead electrocardiography, lying and standing blood pressure, carotid sinus massage (CSM), head-up tilt, cardiac electrophysiological tests, and ambulatory blood pressure and heart rate monitoring, which includes external and internal cardiac monitoring. The presence of structural heart disease predicts an underlying cardiac cause. Conversely, the absence of either indicates that neurally mediated etiology is likely. CSM and tilt-table testing should be considered in patients with unexplained and recurrent falls. Holter monitoring over 24 hours has a low diagnostic yield. Early use of an implantable loop recorder may be more cost-effective. A dedicated investigation unit increases the likelihood of achieving positive diagnoses and significantly reduces hospital stay and health expenditure. Dove Medical Press 2006-03 2006-03 /pmc/articles/PMC2682455/ /pubmed/18047258 Text en © 2006 Dove Medical Press Limited. All rights reserved
spellingShingle Review
Tan, Maw Pin
Kenny, Rose Anne
Cardiovascular Assessment of Falls in Older People
title Cardiovascular Assessment of Falls in Older People
title_full Cardiovascular Assessment of Falls in Older People
title_fullStr Cardiovascular Assessment of Falls in Older People
title_full_unstemmed Cardiovascular Assessment of Falls in Older People
title_short Cardiovascular Assessment of Falls in Older People
title_sort cardiovascular assessment of falls in older people
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682455/
https://www.ncbi.nlm.nih.gov/pubmed/18047258
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