Vasovagal syncope masquerading as unexplained falls in an elderly patient

Area of Science:

• Geriatric Medicine
• Neurology
• Cardiology

Background:

• Recurrent falls are a significant concern in elderly populations, often leading to morbidity and reduced quality of life.
• Identifying the underlying causes of falls is crucial for effective management and prevention strategies in geriatric care.

Observation:

• A 78-year-old female patient presented with a history of recurrent, unexplained falls without available witness accounts.
• Head-up tilt testing revealed vasodepressor vasovagal syncope as a potential cause for her episodes.
• Post-syncope amnesia was noted following loss of consciousness.

Findings:

• Vasodepressor vasovagal syncope was identified as the cause of the patient's falls.
• The patient's falls resolved completely after the discontinuation of specific, implicated medications.

Implications:

• This case underscores the importance of considering vasovagal syncope in the differential diagnosis of unexplained falls in the elderly.
• Medication review and adjustment can be a critical intervention for managing falls caused by syncope, particularly in patients with multiple comorbidities.
• Further research into medication-induced syncope in geriatric populations is warranted to improve diagnostic and therapeutic approaches.