Syncope (2007)

  • Inclusion: Adult
  • Exclusion: Children or for patients whom episode of syncope is thought to be secondary to another disease process
  • Level A:
    • History and PE consistent with heart failure help identify patients at high risk for an adverse outcome.
    • Standard 12-lead ECG
  • Level B:
    • High risk of AE: Older age, structural heart disease, history of CAD
    • Low risk of AE: younger, nonexertional, with out history of or signs of CVD or family history of sudden death and with out co-morbidities
    • Admit patients with syncope and evidence of heart failure or structural heart disease
    • Admit patients with syncope and other factors that lead to stratification as high-risk for adverse outcomes.
      • Older age and associated co-morbidities
      • Abnormal ECG (Acute ischemia, dysrhythmia, or significant conduction abnormalities)
      • HCT < 30 (if obtained)
      • History or presence of heart failure, CAD< or structural heart disease
  • Level C:
    • Lab testing and advanced investigative testing such as echo or cranial CT need not be routinely performed unless guided by specific findings in the History and PE.

Clinical Policy: Critical issues in the evaluation and management of adult patients presenting to the emergency department with syncope. Ann Emerg Med. 2007;49:431-444

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