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A Porcine Model of Acute Autologous Pulmonary Embolism
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[Syncope; suspect pulmonary embolism, especially in the elderly].

W Opstelten1, F L J Visseren

  • 1Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Utrecht.

Nederlands Tijdschrift Voor Geneeskunde
|May 11, 2017
PubMed
Summary
This summary is machine-generated.

Pulmonary embolism (PE) can cause syncope, especially in elderly patients. Always consider PE in syncope evaluations, using the Wells score to rule out this serious condition.

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Area of Science:

  • Emergency Medicine
  • Cardiology
  • Pulmonology

Background:

  • Syncope is a common presenting complaint in emergency departments.
  • While vasovagal response and orthostatic hypotension are frequent causes, pulmonary embolism (PE) can also manifest as syncope.
  • Elderly patients with syncope are a particularly vulnerable group for undiagnosed PE.

Purpose of the Study:

  • To highlight the importance of considering pulmonary embolism in patients presenting with syncope.
  • To emphasize the utility of the Wells clinical decision rule in evaluating syncope patients for PE.
  • To alert general practitioners (GPs) to the potential link between syncope and PE.

Main Methods:

  • Review of clinical presentations of syncope.
  • Application of the Wells clinical decision rule for pulmonary embolism risk stratification.
  • Clinical assessment focusing on vital signs and signs of venous thrombosis.

Main Results:

  • Syncope can be the sole presenting symptom of pulmonary embolism.
  • The Wells score is a crucial tool for excluding PE in syncope patients in the emergency setting.
  • Breathing rate and signs of venous thrombosis are important indicators for GPs.

Conclusions:

  • Pulmonary embolism should be a key differential diagnosis in all syncope presentations, particularly in the elderly.
  • Systematic application of diagnostic tools like the Wells score is essential for timely PE diagnosis.
  • Increased clinical vigilance for PE symptoms is necessary for both emergency physicians and GPs.