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• W2109583797 abstract "Syncope is a common chief complaint in both the emergency department (ED) and the primary care physicians' office. It accounts for approximately 3% of ED visits and 1% of hospital admissions. 5 The list of diagnoses that may have syncope as a symptom is considerable and spans the spectrum from benign disease, such as vasodepressor syncope, to malignant cardiac arrhythmias that may cause sudden death. Only a few studies have attempted to determined the incidence and prevalence of the underlying conditions that manifest with syncope. Of those, some studies report the cause of syncope broadly (e.g., cardiac vs. noncardiac) rather than noting a specific cause (e.g., ventricular tachycardia). The lack of a “gold standard” for the diagnosis of syncope makes the interpretation of these studies difficult. Based on the published evidence, however, it appears that the commonest causes of syncope include 5 , 7 , 16 , 19 1 Cardiac (4%–25%) 2 Vasodepressor vasovagal (8%–37%) 3 Orthostatic hypotension (4%–10%) 4 Micturition syncope (1%–2%) 5 Hypoglycemia (2%) 6 Unknown etiology (13%–41%) Establishing a diagnosis in patients with syncope is important because an accurate and timely diagnosis can effect potentially life-saving treatments. The cause of syncope often eludes the clinician despite extensive efforts to make a diagnosis. In that group of patients for whom the cause has eluded the clinician, it is unclear which patients need a rapid inpatient work-up and which patients can be safely discharged for outpatient evaluation. These authors undertook a systematic literature search to determine the diagnostic value of the ED work-up of the patient with syncope. The structured literature search was conducted as follows: 1 MEDLINE search from 1966 through December, 1997 limited to English language and using the keywords: syncope, diagnosis, blood, urine, metabolism, CT scan , electrolytes, sodium, potassium, blood cell count, blood glucose, electrocardiography, beta human chorionic gonadotropin (HCG) 2 Examination of the reference list of the syncope chapter of a core emergency medicine textbook 14 3 Examination of the reference lists from a sampling of large, recently published review articles on syncope 3 , 8 , 11 , 12 4 Examination of the reference lists of all articles identified in items 1 to 3 above Included were articles in the initial evaluation if they addressed methods that can be used in the ED to diagnose the cause of syncope or aid in decisions regarding patient disposition. These methods included the patient's history, physical examination, complete blood cell count (CBC), electrolytes, computed tomography (CT) of the brain, urine or serum pregnancy tests, initial electrocardiogram, and continuous electrocardiography (either in the form of inpatient monitoring or outpatient Holter monitoring). Only studies meeting level I or II criteria were included (Table 1) Using this search strategy, 13 articles were identified; all of these articles were classified by the authors as level II." @default.
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• W2109583797 date "1999-02-01" @default.
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• W2109583797 title "EVALUATION OF THE PATIENT WITH SYNCOPE: AN EVIDENCE BASED APPROACH" @default.
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• W2109583797 doi "https://doi.org/10.1016/s0733-8627(05)70052-3" @default.
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