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Unlabelled: Syncope is a common symptom among older adults. Its aetiologic diagnosis is mainly clinical, but when it has an unknown origin, complementary studies are necessary. We present the experience of a single center in diagnosing Unknown Origin Syncope (UOS)., Methods: We performed a transversal retrolective study to assess the different tests done to patients studied because of USO., Results: The mean age of the older group was 77.6 +/- 6.9 years. The 24-hour Hotter were abnormal in 77.9% of patients, but diagnostic in only 16.3%. Age older than 65 years was associated with a 1.9 increase (CI 95% 0.9-4) in the possibilities of having a diagnosis, while age lesser than 65 was associated with a 0.5 risk CI 95% 0.2-1.08 of having a diagnosis. The 48-hour holter showed similar results. Older age was associated with a 1.69 OR, CI 95% 0.6-4.4 to have a positive Tilt test (91% of older patients). They had mainly the vasodepressor variety of neurally-mediated syncope. (57.1% Vs 40.1%, p = 0.01). Of the 6 electrophysiologic studies performed in people older than 65 years, 3 where diagnostic (50% Vs 33.3%, p = 0.6)., Conclusions: Complimentary tests in people elder than 65 years are diagnostic in a higher proportion than in their younger counterparts. Nevertheless there is a higher risk of false-positive results, so tests such as head-up tilt test should be more carefully interpreted.

Unlabelled: Neurocardiogenic syncope (NCS) is diagnosed by means of a head-up tilt table tests (HUTT). This is a prolonged test although early outcome predictors are known., Methods: We conducted a study among patients engaged in a syncope study protocol. We performed HUTT in all of them and compared the basal arterial pressure with the arterial pressure at the end of a the 70 degrees tilting., Results: We performed 185 HUTT studies. Systolic blood pressure (BP) raised 0.9% among patients with a negative test, whereas patients with a positive HUTT showed a 2.3% decrease (p = 0.2) in the same measurement. Diastolic BP increased 34% among negative HUTT patients and 14.9% among patients with positive test (p = 0.02). We calculated a relative risk of 1.45 for positive test when the combination of systolic BD decrease and dyastolic increase was present, according to the percentage of change (IC95%: 1.1 to 7.8)., Conclusions: The combination of systolic BP reduction and diastolic BP elevation at the end of the 70 degrees tilting is associated with an increased risk of having a positive HUTT. These changes might be related to differential sympathetic stimulation.