[Transient loss of consciousness in an internal medicine unit. Study of the initial evaluation and medium-term...

The authors report the results of a study concerning 90 patients admitted to an Internal Medicine Unit for transient loss of consciousness. The cause of this event was found in 74 cases (82%), including 73 where the initial evaluation had been simple, consisting of physical examination, electrolytogram, blood glucose level, electrocardiogram and test for postural hypotension. Patients and physicians reported different frequencies of recurrence (17 and 51% respectively) and complications (27 and 96% respectively). Recurrences were usually multiple and appeared soon after the initial event. A 4% mortality rate was recorded over 21 months, but only one death was due to a cardiovascular cause. No death was observed in the group of patients without initial aetiological diagnosis. Apart from cardiac syncopes, the consequences of transient loss of consciousness seem to be psychological rather than physical. A simple initial evaluation is often sufficient.