Don’t Faint! When Properly Diagnosed, Syncope in Older Adults Can Be Treated

Syncope, or fainting, is common in adults 65 and older, with research suggesting that more than 20% of older adults have syncopal episodes. But today we know that you can live well and stay safe with the condition.

What is Syncope?

It’s regarded as “fainting” or “passing out” when a person loses consciousness and then recovers without intervention. This event may be due to syncope.

A true syncopal episode is caused by a loss of blood flow to the brain. When the brain lacks blood, it also lacks oxygen, causing the person to lose consciousness until the blood and oxygen are restored. Most episodes last only a few minutes.

Syncope causes include:

  • Rapid drops in blood pressure. Also known as orthostatic hypotension, this rapid drop causes oxygen levels in the brain to plunge. It’s similar to the way the temperature drops quickly when a storm moves in.
  • Generally low blood pressure.
  • A change in posture, such as standing up quickly. This is the acute version of the “head rush” people often experience.
  • Extreme stress, fear, or pain.
  • Dehydration.
  • An underlying heart problem.

Diagnosing Syncope

If you have fainted, your doctor will first test you for narcolepsy, epilepsy, and other conditions that can exhibit similar symptoms. Once those conditions have been eliminated, the doctor will typically conduct a tilt-table test.

During this test, you will be strapped to a table that can move. It may feel a little like a slow amusement park ride as your doctor moves the table to try to trigger a syncopal episode in a controlled and monitored environment.

You’ll also be attached to devices that monitor your heart function, your blood pressure, and possibly your brain function. These can give doctors clues to why you lose consciousness.

Treating Syncope

Treatment for your fainting episode or pattern will depend on the cause. If your syncope is due to a heart problem, you may need to have medication and/or a device, like a pacemaker, implanted.

Often in the case of syncope in older adults, the cause is rapidly dropping blood pressure. If you struggle with this, your doctor may recommend movement therapy alongside medication. Your doctor can refer you to a physical therapist who will ensure that you are strong enough to do these exercises, that you have the necessary strength to do them, and that you are moving in ways that are safe for your body.

Denver physical therapist Patrick Donovan, owner of Heather Lane Physical Therapy, says that specific movements that will help the blood flow to your brain include targeted techniques in:

  • Squeezing your leg muscles
  • Gripping
  • Squatting
  • Crossing and uncrossing your legs

For some types of syncope, aerobic exercise also may be helpful. Your doctor can assess whether this is a good treatment for you and alert your physical therapist.

Prognosis for syncope patients

Syncope can feel debilitating, but it doesn’t have to be that way! Getting an accurate diagnosis of the causes of your condition can help you find the medication, surgery, or movement treatment that is right for you.

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Goyal, P., & Maurer, M. S. (2016). Syncope in older adults. Journal of geriatric cardiology : JGC, 13(5), 380–386. doi:10.11909/j.issn.1671-5411.2016.05.002
Petkar, S., Cooper, P., & Fitzpatrick, A. P. (2006). How to avoid a misdiagnosis in patients presenting with transient loss of consciousness. Postgraduate medical journal, 82(972), 630–641. doi:10.1136/pgmj.2006.046565
Raj, S. R., & Coffin, S. T. (2013). Medical therapy and physical maneuvers in the treatment of the vasovagal syncope and orthostatic hypotension. Progress in cardiovascular diseases, 55(4), 425–433. doi:10.1016/j.pcad.2012.11.004
Takahagi, V. C., Costa, D. C., Crescêncio, J. C., & Gallo Junior, L. (2014). Physical training as non-pharmacological treatment of neurocardiogenic syncope. Arquivos brasileiros de cardiologia, 102(3), 288–294. doi:10.5935/abc.20140021

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