Recurrent syncope: differential diagnosis and management

Bennett, Matthew T.; Leader, Nathan; Krahn, Andrew D.

doi:10.1136/heartjnl-2014-306627

Cited by 13 publications

(9 citation statements)

References 71 publications

(36 reference statements)

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“…This is higher than previous evaluations of syncope, which has been estimated between 2 to 20% over a lifetime. 9,12,13 This may be due to the older age of our population. The risk of adverse cardiovascular events was higher in those with a previous reported history of syncope.…”

Section: Discussionmentioning

confidence: 92%

“…15 Bennett et al include risk factors for high risk syncope as those over the age of 60 with previous cardiac history. 9 Sheldon et al found that older patients were more likely to have cardiac causes of syncope, including complete heart block, SVT, and VT with a median of two syncopal spells. 10 Longitudinal studies show that those with recurrent syncope tends to have worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

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Recurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes

Chang

Hollander

et al. 2019

The American Journal of Emergency Medicine

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Almost 20% of patients with syncope will experience another event. It is unknown whether recurrent syncope is a marker for a higher or lower risk etiology of syncope. The goal of this study is to determine whether older adults with recurrent syncope have a higher likelihood of 30-day serious clinical events than patients experiencing their first episode. Methods: This study is a pre-specified secondary analysis of a multicenter prospective, observational study conducted at 11 emergency departments in the US. Adults 60 years or older who presented with syncope or near syncope were enrolled. The primary outcome was occurrence of 30-day serious outcome. The secondary outcome was 30-day serious cardiac arrhythmia. In multivariate analysis, we assessed whether prior syncope was an independent predictor of 30-day serious events. Results: The study cohort included 3580 patients: 1281 (35.8%) had prior syncope and 2299 (64.2%) were presenting with first episode of syncope. 498 (13.9%) patients had 1 prior episode while 771 (21.5%) had more than 1 prior episode. Those with recurrent syncope were more likely to have congestive heart failure, coronary artery disease, previous diagnosis of arrhythmia, and an abnormal ECG. Overall, 657 (18.4%) of the cohort had a serious outcome by 30 days after index ED visit. In multivariate analysis, we found no significant difference in risk of events (adjusted odds ratio 1.09; 95% confidence interval 0.90-1.31; p=0.387). Conclusion: In older adults with syncope, a prior history of syncope within the year does not increase the risk for serious 30-day events.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Recurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes

Chang

Hollander

et al. 2019

The American Journal of Emergency Medicine

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“…132 À134 Injuries from syncope related falls include fractures, intracranial haemorrhage, internal organ injury and neurologic injury and accounts for approximately 30% of patients admitted to emergency rooms. 135 Syncope may be of vasovagal (50%) or orthostatic (7%) or cardiac (7%) origin 136 and there is laboratory evidence to suggest that physical counterpressure manoeuvres may abort syncope if applied in the presyncopal phase. 137À140 Physical counterpressure manoeuvres (PCM) include muscle contraction of the large muscles of arms, legs and abdomen -leg-pumping, tensing, crossing, squatting, handgrip, and abdominal compression (Fig.…”

Section: Management Of Presyncopementioning

confidence: 99%

European Resuscitation Council Guidelines 2021: First aid

Zideman¹,

Singletary

Borra³

et al. 2021

Resuscitation

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The European Resuscitation Council has produced these first aid guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics include the first aid management of emergency medicine and trauma. For medical emergencies the following content is covered: recovery position, optimal positioning for shock, bronchodilator administration for asthma, recognition of stroke, early aspirin for chest pain, second dose of adrenaline for anaphylaxis, management of hypoglycaemia, oral rehydration solutions for treating exertion-related dehydration, management of heat stroke by cooling, supplemental oxygen in acute stroke, and presyncope. For trauma related emergencies the following topics are covered: control of life-threatening bleeding, management of open chest wounds, cervical spine motion restriction and stabilisation, recognition of concussion, cooling of thermal burns, dental avulsion, compression wrap for closed extremity joint injuries, straightening an angulated fracture, and eye injury from chemical exposure.

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“…[138]. Die Synkope kann vasovagalen (50 %) oder orthostatischen (7 %) oder kardialen (7 %) Ursprungs sein [139]. Es gibt Laborergebnisse, die darauf hindeuten, dass physikalische Gegendruckmanöver eine Synkope verhindern können, sofern sie in der präsynkopalen Phase angewandt werden [140][141][142][143].…”

Section: Andere Rehydrierungslösungen Im Vergleich Zu Wasserunclassified

First aid

Zideman¹,

Singletary

Borra

et al. 2021

Notfall Rettungsmed

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Zusammenfassung Diese Erste-Hilfe-Leitlinien beruhen auf dem internationalen, wissenschaftlichen Konsens 2020 zur kardiopulmonalen Wiederbelebung mit Behandlungsempfehlungen und wurden vom European Resuscitation Council erstellt. Die Themen umfassen das Erste-Hilfe-Management im Bereich Notfallmedizin und Traumata. Im Themenbereich medizinische Notfälle werden folgende Inhalte behandelt: Seitenlagerung, optimale Lagerung eines Betroffenen im Kreislaufschock, Gabe von Bronchodilatatoren bei Asthma, Erkennung eines Schlaganfalls, frühe Gabe von Acetylsalicylsäure bei Brustschmerzen, Zweitgabe von Adrenalin bei Anaphylaxie, Behandlung einer Unterzuckerung/Hypoglykämie, orale Gabe von Rehydrierungslösungen zur Behandlung eines erschöpfungsbedingten Flüssigkeitsmangels, Behandlung eines Hitzschlags durch Kühlung, Sauerstoffgabe bei akutem Schlaganfall und Benommenheit. Im Themenbereich Trauma werden folgende Themen behandelt: Stillung lebensbedrohlicher Blutungen, Behandlung offener Brustkorbverletzungen, Stabilisierung und Immobilisation der Halswirbelsäule, Erkennung von Gehirnerschütterungen, Kühlung von Verbrennungen, Zahnverlust, Kompressionsverband bei geschlossenen Gelenkverletzungen an Extremitäten, Reponierung von Frakturen mit Fehlstellung sowie Augenverletzungen durch chemische Stoffe.

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Recurrent syncope: differential diagnosis and management

Cited by 13 publications

References 71 publications

Recurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes

Recurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes

European Resuscitation Council Guidelines 2021: First aid

First aid

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