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The heart and falls

In the same way that a drop in blood pressure can reduce blood flow to the brain, if the heart slows down too much it can also reduce the blood flow to the brain. This can cause lightheadedness, fainting and falls.

Some people with a very slow heart will just drop down for no obvious reason. Below are a few cardiac conditions which can slow the heart rate down and cause falls.

Vasovagal Syncope (fainting)

We saw on the previous page that Vasovagal Syncope can cause a sudden drop in blood pressure, but it can also cause a sudden slowing down of the heart.

Carotid Sinus Syndrome

Again, this condition, which we saw on the previous page, can cause either drops in blood pressure or a sudden slowing down of the heart.

Conduction problems

Within the heart we have our own natural pacemaker, from which an electrical signal is generated. This signal then passes down through a network of wires in the heart to cause a smooth and organised heartbeat. Sometimes our pacemaker becomes inefficient and our heart rate can become too slow. Or, the pacemaker may be working but the wires do not let the signal through, causing the heart to miss a beat. When the heart slows down too much it can result in dizziness, fainting or falls.

Warning signs that the heart may be causing falls

  • Lightheadedness. If it only occurs while standing up, it suggests it is low blood pressure, but if it occurs while sitting or lying down it could be a slow heart rate.
  • Suddenly falling down for no reason. A sudden slowing of the heart may cause people to just drop down with no apparent loss of consciousness or fainting.
  • Injuring the face when falling. This usually means that the hands were not put out to protect the head during a fall. In this situation we should consider the heart.
  • Fluttering or pain in the chest before the fall.

Treatments

Firstly, if we can avoid situations which may precipitate a problem. This might be avoiding the heat or prolonged standing in people with vasovagal syncope. Next we should always review our medication with a physician as some medications can slow the heart down or even affect the electrical signals in the heart. If simple solutions are not possible and the falls are frequent and troublesome we should consider placing a pacemaker. This is a small electronic device which sits underneath the skin on the chest, just below the left collar bone. The device is connected to the heart with wires to stimulate it to beat, but only if and when our heart goes too slowly. More information about pacemakers can be found on the British Heart Foundation website. This website includes details about how the device is inserted and also includes video case studies from people who have pacemakers.

Remember, most falls are not due to heart problems so please do not worry. But it is useful to be aware of the warning signs, both for yourself, but also for your friends and family.

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Ageing Well: Falls

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