Syncope: is it a misunderstood syndrome?

Syncope is a frequent reason for emergency department visits and the overall admissions of the elderly. The causes of syncope are diverse and clinicians use a wide range of investigations to try to achieve a diagnosis. Moreover, syncope in the elderly should be considered as a symptom of the neuro-cardiovascular instability (NCVI) syndrome even though it has not to be excluded as the expression of an underlying disease. The aim of the study was to assess care setting in over 75-year old population admitted to emergency room for syncope and its complications to improve their management, both in the in-patient and the out-patient settings. Despite syncope is the most frequent cause of emergency room admittance in the elderly, in our study it seems to be underestimated as a symptom denouncing high morbidity and mortality disease such as heart disease and stroke. A stronger attention and a new age-tailored strategy for the management of in-patient and out-patient care of syncope is envisaged.