An Elderly Woman Who Falls - An Unexpected Cause...

Half of all falls in the elderly are likely due to fainting or "syncope." The cause of syncope is "reflex" or vasovagal in about 2/3 of all patients. In this Clinical LiveStream I present a case of a 90 year old woman with numerous falls and dizzy/fainting episodes that were sudden in onset and associated with rapid palpitations. We will discuss her history, the testing that was attempted, and the one ECG that finally confirmed the diagnosis and led her to a "cure."
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[@ECGDoc]

Thanks to all of you who tuned in. Still having sync problems but please try to bear with it... it's only on the full screen video shots.

[@thomaslapsley8145]

I like the ectopic and sinoatrial node beats representation of superposition of waves. Fourier analysis. I am new to learning cardiology but, what I am finding is in many departments in medicine many people are poorly trained in cardiology and the tendency is to say atrial fibrillation, ignore the elderly patient. In fact many times it is not atrial fibrillation. They really should take your course. What I like with your presentations is that the ECGDoc does not teach pattern matching, he encourages students to think and look into the details. His advanced course is not for the beginner but, in his other courses there is a beginning level.

[@mohammedalattar5546]

Amazing lec doc.. thanks very much

[@spacefed101]

Outstanding lecture !

[@ECGDoc]

Thanks!

[@malinigowda971]

thanks lot

[@daviddesosa]

If I am not mistaken BW 10th edition states a 33% of orthostatic hipotension as sincope cause, and neurocardiogenic a 20%. Do you think this percentages are right?

[@ECGDoc]

I don't agree. Orthostatic hypotension is not that common except in patients who are on meds like diuretics, or in patients with underlying neurological conditions like Parkinson's disease. "Neurocardiogenic" syncope is more common at all age groups, but as I mention in the discussion many elderly patients do not have the typical "vagal" signs or a prolonged prodrome of nausea, feeling hot, lightheadedness, etc. Sometimes they lack the "early warning system" that younger people have that results in symptoms of impending loss of consciousness, and as a result they just go down suddenly. Sometimes the differences in reporting causes are related to differing definitions and investigator bias.