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[Syncope: general characteristics and its relation to age]
Insights
A definite cause for syncope was found in 62% of patients, with most cases being cardiovascular. This study highlights key diagnostic tools for identifying the origin of syncope in hospitalized patients.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Diagnostics
Context:
- Syncope is a common clinical presentation requiring accurate diagnosis.
- Understanding the etiology of syncope is crucial for patient management and prognosis.
- This study examines causes and diagnostic methods for syncope in a general hospital setting.
Purpose:
- To retrospectively analyze the causes of syncope in 146 hospitalized patients.
- To identify the diagnostic tools most effective in determining the origin of syncope.
- To assess the distribution of cardiovascular versus non-cardiovascular causes of syncope.
Summary:
- A definite or highly likely cause of syncope was identified in 91 patients (62%).
- Cardiovascular origins accounted for 78% of identified causes, including conduction defects and sinus node disease.
- Non-cardiovascular causes comprised 22%, with intoxication and vasovagal episodes noted. Diagnosis relied on history, physical examination, ECG, Holter monitoring, and echocardiography.
Impact:
- Establishes the prevalence of cardiovascular causes in hospital-diagnosed syncope.
- Provides insights into the utility of various diagnostic modalities for syncope.
- Informs clinical practice regarding the workup and management of syncope patients, with a low in-hospital mortality of 2%.
Abstract:
We retrospectively analyzed the clinical data of 146 patients admitted to a general hospital with the diagnosis of syncope. A definite or highly likely cause was identified in 91 patients (62%). These were of cardiovascular origin in 78%: conduction defects (31), sinus node disease (9), obstructive causes (8), ventricular arrhythmia (8), ischemia (5) and miscellaneous (14). A non cardiovascular origin was present in 22% of patients: intoxication (7), hysteria (5), hypoxemia (3), vasovagal (2), gastrointestinal bleeding (2) and 2 others. The final diagnosis in patients with a known cause was established by the history and physical examination in 16, the ECG in 42, Holter 9, ECG monitoring in ICU 8 and echocardiogram 6. No difference in the distribution of causes was present between patients below or above 65 years of age. In hospital mortality was 2%.