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Syncope: current diagnostic evaluation and management.

A S Manolis1, M Linzer, D Salem

  • 1New England Medical Center Hospital, Boston, Massachusetts.

Annals of Internal Medicine
|June 1, 1990
PubMed
Summary
This summary is machine-generated.

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Syncope, a common condition affecting up to 50% of adults, requires a stepwise diagnostic approach. Cardiac syncope has the worst prognosis, necessitating prompt evaluation and treatment.

Area of Science:

  • Cardiology
  • Neurology
  • Internal Medicine

Background:

  • Syncope is a prevalent clinical issue affecting 30-50% of the adult population.
  • The prognosis of syncope is highly dependent on its underlying cause, with cardiac syncope posing the greatest risk.

Purpose of the Study:

  • To comprehensively review the causes, diagnostic evaluation, and treatment of syncope.
  • To outline a rational, stepwise approach for diagnosing and managing syncope patients.

Main Methods:

  • A critical analysis of new data and knowledge in the field of syncope.
  • A MEDLINE search supplemented by selective review of English language literature and clinical experience.
  • Inclusion of articles addressing pathophysiology, classification, causes, differential diagnosis, and evaluation methods for syncope.

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Main Results:

  • Noninvasive testing identifies the cause of syncope in approximately 50% of cases.
  • Invasive electrophysiologic studies are crucial for selected patients with structural heart disease and unexplained syncope.
  • Tilt-table studies show promise as a noninvasive tool for diagnosing vagally mediated syncope.

Conclusions:

  • A systematic diagnostic and therapeutic strategy for syncope involves a thorough history, physical examination, noninvasive evaluation, and selective advanced testing.
  • Future research should validate current diagnostic tests and further elucidate the pathophysiology of recurrent, unexplained syncope.