Related Experiment Video

Updated: Aug 15, 2026

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
14:09

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance

Published on: March 21, 2013

Mortality outcomes of various causes of syncope

John R Iacovino

    Journal of Insurance Medicine (New York, N.Y.)
    |April 24, 2004
    PubMed

    Insights

    Syncope in older applicants poses underwriting challenges. Unknown or vasovagal causes show increased mortality, with cardiac syncope indicating the highest risk, impacting insurance risk selection.

    Area of Science:

    • Cardiology
    • Gerontology
    • Epidemiology

    Background:

    • Syncope presents significant risk selection challenges in older individuals.
    • Establishing a definitive cause for syncope is often difficult, complicating underwriting.
    • Accurate mortality risk assessment is crucial for insurance medical directors.

    Purpose of the Study:

    • To analyze the mortality outcomes associated with various causes of syncope.
    • To provide data for underwriting decisions concerning applicants with syncope of unknown etiology.
    • To inform risk classification based on established syncope causes.

    Main Methods:

    • Analysis of mortality data from Framingham Heart Study participants over a 24-year period.
    • Categorization of syncope causes including unknown, vasovagal, neurogenic, and cardiac.
    • Calculation of mortality ratios and excess death rates for each syncope category.

    Main Results:

    • Syncope from vasovagal or other causes showed a 14% mortality ratio.
    • Neurogenic syncope had a 168% mortality ratio; unknown cause syncope had a 192% mortality ratio.
    • Cardiac syncope exhibited the highest mortality ratio at 270%, with no excess mortality for seizure-related syncope when excluded.

    Conclusions:

    • Syncope of unknown etiology or vasovagal origin is associated with increased mortality.
    • Cardiac syncope represents a substantial mortality risk, requiring careful underwriting.
    • These findings aid in actuarial assessments for insurance applicants with syncope.

    More Related Videos

    Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research03:13

    Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research

    Published on: November 3, 2023

    Mouse Cardiac Arrest Model for Brain Imaging and Brain Physiology Monitoring During Ischemia and Resuscitation07:18

    Mouse Cardiac Arrest Model for Brain Imaging and Brain Physiology Monitoring During Ischemia and Resuscitation

    Published on: April 14, 2023

    Related Concept Videos

    Decreased pulse rate01:14

    Decreased pulse rate

    Bradycardia is a medical condition in which the heart rate is slower than normal. It occurs when the heart's natural pacemaker, the sinus node, generates slower electrical impulses than the standard rhythm. In adults, bradycardia is diagnosed when the pulse rate falls below 60 beats per minute, indicating a deviation from the normal heart rate range.
    There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with bradycardia...
    Coronary Artery Disease III: Clinical Manifestations01:30

    Coronary Artery Disease III: Clinical Manifestations

    Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
    Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

    Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

    The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
    Heart Failure III: Clinical Manifestations01:26

    Heart Failure III: Clinical Manifestations

    Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
    Hemorrhagic Stroke ll: Pathophysiology01:29

    Hemorrhagic Stroke ll: Pathophysiology

    A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
    Transient Ischemic Attack l: Introduction01:26

    Transient Ischemic Attack l: Introduction

    A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...