Related Experiment Videos
A novel device in evaluating syncope
1Department of Medicine, University of Miami School of Medicine, Fla, USA.
Insights
Diagnosing syncope, or fainting, can be challenging. A detailed history, physical exam, and new tools like the Reveal Plus loop recorder aid in identifying causes and improving patient outcomes.
Area of Science:
- Cardiology
- Neurology
Background:
- Syncope, or fainting, presents a diagnostic challenge due to diverse underlying etiologies.
- Accurate diagnosis requires thorough patient history and physical examination.
Observation:
- Common causes include reflex-mediated syndromes (vasovagal) in young adults and orthostatic hypotension in the elderly.
- Postprandial syncope after heavy meals is an often-overlooked cause in the elderly.
- Cardiac syncope carries a significantly higher 1-year mortality rate (18%-33%) compared to non-cardiac syncope (0%-12%).
Findings:
- The Reveal Plus insertable loop recorder offers a reliable, cost-effective method for capturing arrhythmic events.
- This device aids in the diagnosis of syncope through automatic and patient-activated event recording.
- The recorder's 12-14 month duration provides extended monitoring capabilities.
Implications:
- Improved diagnostic accuracy for syncope can lead to timely and appropriate treatment.
- Utilizing advanced monitoring tools like loop recorders can reduce healthcare costs and improve patient management.
- Early identification of cardiac syncope is crucial due to its higher mortality risk.
Abstract:
Syncope may be a manifestation of many diseases. The etiology is often difficult to determine. Much effort, time, and expense have been required to determine a diagnosis. A thorough history and physical examination are essential (Table 3). Several clinical pearls may be of help in the diagnosis of syncope: (a) the most important elements in the evaluation of syncope are a detailed history and physical examination; (b) syncope is a common problem in young healthy adults and the elderly; (c) a heavy meal is a specific cause of syncopy in the elderly (postprandial), however this etiology often goes unrecognized; (d) syncope is caused by 1 of 3 mechanisms: decreased cardiac output, systemic vascular resistance, or cerebrovascular disease; (e) reflex-mediated syndromes (vasovagal) are common causes of syncope in young adults, and orthostatic hypotension is an important cause of syncope in the elderly; and (f) the 1-year mortality of cardiac syncope (18%-33%) is significantly higher than that from non-cardiac syncope (0%-12%). A proven and useful tool has recently been advanced to aid in the evaluation of syncope. The Reveal Plus insertable loop recorder has auto activation that allows automatic capture and recording of arrhythmic events. Patient activation is an option. The recorder lasts 12 to 14 months and has proven to be a valuable and reliable cost-effective asset in our quest to evaluate syncope.