Falls, Dizziness and Syncope in older people - eLearning Site of APLCGG

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位置: eLearning Site of APLCGG > e-Learning > Geriatrics Fellowship Teaching Schedule > 2013 Taiwan Hypertension, Orthostatic Hypotension and Syncope

Falls, Dizziness and Syncope in older people (1:34:51)

by aplcgg, 2013-09-17 16:52, 人氣(1019)

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標題

1. Hypertension, Orthostatic hypotension & Syncope

2. Slide 2

3. Deaths attributed to 19 leading factors,by country income level, 2004

4. Prevalence of hypertension over 80 years

5. Prevalence of hypertension over 80 years

6. Taiwanese Survey on Hypertension, Hyperglycemia, and Hyperlipidemia (TwSHHH)

7. Evidence for BP-lowering treatment in older people?

8. BP control in the elderly

9. Evidence for BP-lowering treatment in older people?

10. BP control in the elderly

11. ‘INDANA’ Meta-analysis 1999 in pts >80y

12. Slide 9

13. ‘INDANA’ Meta-analysis 1999 in pts >80y

14. Slide 9

15. Fatal Stroke(39% reduction)

16. Heart failure(64% reduction)

17. Total mortality(21% reduction)

18. Life Expectancy at 70+

19. Lifestyle Modification – never too late

20. Impact of a 5 mmHg SBP Reduction

21. Specific aspects in the elderly hypertensive patient

22. Slide 17

23. SYNCOPE – a particular kind of fall

24. Causes of syncope

25. Syncope Incidence vs. AgeFramingham data. Soteriades, NEJM 2002

26. Syncope and mortalityFramingham data. Soteriades, NEJM 2002

27. Older people and syncope - outcomes

28. Syncope – risks for poor outcome

29. Classification of true syncope European Society of Cardiology

30. Carotid sinus syndrome

31. Carotid sinus syndrome

32. CSH - History

33. CSH in older people

34. Cause

35. Reflex syncope – Pathophysiology

36. CSS Pathophysiology

37. Carotid sinus massage – Mrs. MB

38. Pacing Intervention (for CSH VDR)

39. Follow-up Carotid sinus massage 8/52 post stopping Timolol drops

40. Orthostatic hypotension

41. Orthostatic hypotension

42. Orthostatic Hypotension in Older PeopleCardiovascular Health Study (n=4931) age >65y

43. OH Symptoms

44. Complications of OH

45. OH and mortalityHonolulu Heart Program, n=3522, f/up 4 yearsJapanese-America men age 71-93yrs old

46. Treatment of vasodepressor carotid sinus syndrome, Vaso-vagal syncope, Orthostatic hypotension

47. Sustained benefit of water drinking in OH

48. Drugs to treat CSH (VDR), OH, Vaso-vagal syncope

49. Assessment of suspected syncope

50. History - including witness if availableECGLying and standing blood pressure - Supine for at least 10 minutes, standing for 3 minutes24-hour ECG - pick-up very low if ECG normalEchocardiogram - If aortic stenosis suspected clinically - or low ejection fraction (ventricular arrhythmia more likely)Tilt-table testing

51. Tilt table testing

52. Mr RD

53. Catching the Arrhythmia…

54. Catching the Arrhythmia…

55. A dizzy patient

56. Catching the Arrhythmia…

57. A dizzy patient

58. A dizzy patient

59. Ageing - Dizziness

60. Hallpike’s test

61. BPPV

62. Questions?

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