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Influence of age and gender on the occurrence and presentation of reflex syncope
Abstract
Background The clinical history is the cornerstone of diagnosing patients with transient loss of consciousness (TLOC). Reflex syncope is the most common cause of TLOC in patients across all ages. Knowledge of the variation in incidence and clinical features of reflex syncope by age and gender provides important background information to acquire an accurate diagnosis.Methods In a cohort of 503 patients presenting with TLOC we established a final diagnosis after systematic evaluation and two years of follow-up. The occurrence of prodromal signs, symptoms, and triggers in patients with reflex syncope was analyzed by both age (< 40 yrs, 40-59 yrs and > or = 60 years) and gender.Results Reflex syncope was the most frequently obtained diagnosis (60.2%) in patients of all ages presenting with TLOC. Its occurrence was higher in patients under 40 years (73.4%), than above 60 years of age (45.3%). Pallor (79.9%), dizziness (73.4%), and diaphoresis (63.0%) were the most frequently reported prodromal signs and symptoms. Most triggers and prodromal signs and symptoms were more common in patients under 40 years of age and in women.Conclusions Reflex syncope is nearly twice as common in patients under 40 years of age than in patients aged 60 years or above. Typical signs and symptoms of reflex syncope are more common in younger patients and in women. Therefore, age and gender provide important diagnostic information and can help to decide whether additional testing is necessary.
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“Comorbidity influences the diagnosis of syncope and management decisions. 33,375”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [375]
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Developed in collaboration with, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), and Heart Rhythm Society (HRS), societies, E. B. T. F., European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), et al. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp298 · Cited by 2,040
Self-citation2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951
2018 ESC Guidelines for the diagnosis and management of syncope
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Guía de práctica clínica para el diagnóstico y manejo del síncope (versión 2009)
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Metadata
- Authors
- Romme, J. J. C. M., van Dijk, N., Boer, K. R., Dekker, L. R. C., Stam, J., Reitsma, J. B., & Wieling, W.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Romme, Jacobus J. C. M.
- Venue
- Clinical Autonomic Research
- Published
- 2008-04-30
- Volume
- 18
- Issue
- 3
- Pages
- 127-133
- ISSN
- 0959-9851 (ISSN-L)
- 1619-1560
- OpenAlex
- W2155882327
- Cited by
- 115
- References
- 39
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 3 · 2022: 15 · 2021: 9 · 2020: 5 · 2019: 4 · 2018: 8 · 2017: 4 · 2016: 4 · 2015: 6 · 2014: 10 · 2013: 6 · 2012: 5
- FWCI
- 9.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Clinical Autonomic Research (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- TU/e Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Keywords
- reflex syncope, transient loss of consciousness, age differences, gender differences, prodromal symptoms, syncope triggers, pallor, dizziness, diaphoresis, syncope diagnosis
- MeSH terms
- Adult, Age Factors, Aged, Diagnosis, Differential, Epilepsy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Sex Factors, Syncope, Cohort Studies, Incidence, Multivariate Analysis
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