Early and late-onset syncope: insight into mechanisms

Area of Science:

• Cardiology
• Neurology
• Geriatrics

Background:

• Unexplained syncope presents a significant clinical challenge.
• The impact of age at first syncope on final diagnosis remains understudied.

Purpose of the Study:

• To investigate the influence of age at first syncope on the final diagnosis of unexplained syncope.
• To analyze clinical characteristics and syncope diagnoses in relation to age at first syncope and investigation.

Main Methods:

• Stratified 1928 head-up tilt patients into age groups (<30, 30-59, ≥60 years) based on age at first syncope.
• Analyzed clinical data and final syncope diagnoses in relation to age at first syncope and investigation.

Main Results:

• Syncope incidence shows a bimodal distribution, peaking at 15 and 70 years.
• Early-onset syncope (<30 years) is associated with prodromes and vasovagal syncope (VVS).
• Late-onset syncope (≥60 years) is linked to orthostatic hypotension (OH), carotid sinus syndrome (CSS), and complex syncope.

Conclusions:

• Age at first syncope is a critical factor in diagnosing unexplained syncope.
• Older patients with syncope are more likely to have OH and CSS.
• Younger patients with syncope more frequently experience prodromes, VVS, and complex syncope.