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Related Experiment Videos

Diagnosing syncope. With an emphasis on cardiac causes.

J L Vacek1

  • 1Mid-America Cardiology Associates, Kansas City, MO 64111.

Postgraduate Medicine
|October 1, 1991
PubMed
Summary

Syncope evaluation can be costly and inconclusive. Patients without heart disease and an unknown syncope cause have an excellent prognosis, despite potential symptom recurrence.

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Syncope evaluation is often lengthy, expensive, and diagnostic rates are low.
  • Prognosis is tied to underlying conditions, not syncope itself.
  • Recurrent syncope does not necessarily indicate a poor prognosis.

Purpose of the Study:

  • To outline the diagnostic and prognostic implications of syncope evaluation.
  • To define the role of primary care physicians in initial syncope management.

Main Methods:

  • Review of diagnostic approaches for syncope.
  • Assessment of prognostic factors in patients with syncope.
  • Evaluation of the utility of Holter monitoring, echocardiography, and signal-averaged electrocardiography.

Main Results:

  • Up to 50% of syncope evaluations do not yield a diagnosis.
  • Prognosis is excellent for patients with no organic heart disease and an undiagnosed cause of syncope.
  • Primary care physicians can manage most initial syncope evaluations.

Conclusions:

  • Initial syncope evaluation and management can be handled by primary care physicians with access to standard cardiac diagnostic tools.
  • Cardiology consultation is reserved for cases with unrevealing initial evaluations or complex findings.
  • A definitive diagnosis is not always necessary for a good prognosis in syncope patients without underlying heart disease.

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