Cardiovacular causes of falls in the elderly

These include:

Neurally mediated syndrome

• vasovagal (neurocardiogenic) syncope
• carotid sinus syndrome
• postural hypotension: - secondary to intercurrent illness aggravated by chronic venous insufficiency - age associated autonomic neuropathy - drugs (diuretics, nitrates, tricyclic antidepressants, sedatives hypnotics and neuroleptics)

Cardiac abnormalities

• arrhythmias: - Age associated idiopathic fibrosis of conducting tissue may cause sino-atrial exit block, sick sinus syndrome, paroxysmal AF or heart block.
• structural abnormalities – valvular stenosis, hypertrophic obstructive cardiomyopathy, aortic dissection

Miscellaneous

• pulmonary embolism
• TIA
• subclavial steel syndrome (1)

Reference:

• (1) Carey BJ, Potter JF. Cardiovascular causes of falls. Age and Ageing 2001;30-S4:19-24