Malaises et pertes de connaissance du sujet âgé: évaluation prospective des méthodes d'investigation

60 consecutive patients (mean age: 80,7 yrs; s.d.: 6,1 yrs; range 70-94 yrs) referred to a geriatric medicine department with syncope or dizziness were proposectively compared with 40 age and sex matched controls. A battery of non-invasive investigations including tilt-test, glycemia, 12 lead ecg., eeg, 24 hour ambulatory ecg recording,. M--mode echocardiogram and cervical Doppler velocimetry was applied blindly to patients and controls. The proportion of abnormalities was similar in both groups having sick sinus syndrom or complete atrio-ventricular block versus no control (p less than 0.05). By contrast history-case was of great predictive value: 6 of 13 patients reporting abrupt syncope had a 24 ecg recording showing sick sinus syndrom or complete atrio ventricular block, versus 2 of 47 other patients (p less than 0,01); 11 of 14 patients reporting orhostatic dizziness or syncope had a tilt-test consistent with orthostactic hypotension versus 6 of 46 other patients (p less than 0,01).