Eiffi€ft
Yang Rui-Min
SYNCOPE
OFTHE
ELDERLY
Syncope involves dizziness, cold
sweats, pallor, low blood pressure and
even temporary loss ol consciousness.
Occasionally, urinary incontinence or
convulsion
of
the
limbs occur. Causes
vary.
"Cardiogenic shock" is common
in
the elderly
as
they often
have
coro-
naries or hypertensive heart
disease,
heart enlargement, inegular heart beats
or
even heart tailure.
"Vaso-vagal
syncope"
is
also common and due to
reflex stimulation ol the vagus nerve
in
the
neck,
or it
could also be due
to
inappropriate positional change,
e.9.,
rising rapidly from
a
squatting or sitting
position - blood vessels
of
the elderly
are
less elastic
to accommodate
such
rapid changes
and
blood flow
to
the
brain is
momentarily interrupted.
On
lying
flat again,
all
symptoms disappear
promptly.
lf
the neck is turned
too
suddenly, atherosclerosis
of
the
neck
vessels
may
also precipitate
syncope.
Other causes
of
syncope are
related
to:
vascular pathology
of
the
brain;
organic
diseases
of
the esophagus (swallowing
tube)
-
syncope occurs
during
swallowing. Cough syncope is due to
too violent
coughs
and
"micturition
syncope"
is
usually due
to
sudden
pressure releases upon emptying
an
over-distended bladder. Similar events
may occur
with
over-straining during
bowel opening.
The elderly should
get
up
gradually and
avoid:
violent coughs,
wearing of high collar or
hard
collar
dresses, constipation or an over-dis-
tended
bladder. Take
time for moder-
ate
physical exercises.
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