Diagnosis and evaluation of syncope in the emergency department.
With a careful history, physical examination, and directed investigation, physicians can determine the likely cause of syncope in more than 50% and perhaps up to 80% of patients. Understanding the cause of syncope allows clinicians to determine the disposition of high- and low-risk patients. Patients with a potential malignant cause, such as a cardiac or neurologic condition, should be treated and admitted. Those with benign causes can be safely discharged. This article reviews the diagnosis and ED work-up of syncope, the different classifications of syncope, and prognosis. The use of specific decision rules in risk stratification and syncope in the pediatric population are discussed in another article.
Ouyang
Helen
H
Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Neville House, Boston, MA 02115, USA. houyang@partners.org
Quinn
James
J
D000367:Age Factors; D000368:Aged; D019411:Clinical Laboratory Techniques; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D006801:Humans; D008487:Medical History Taking; D008875:Middle Aged; D010808:Physical Examination; D011379:Prognosis; D012307:Risk Factors; D013575:Syncope / Q000145:classification / Q000175:diagnosis* / Q000209:etiology; D019462:Syncope, Vasovagal / Q000175:diagnosis