Mauricio Duque-Ramírez, Facultad de Medicina, Posgrado de Cardiología, Universidad CES; PUL.SOS. Medellín, Colombia
Laura Duque-González, Facultad de Medicina, Posgrado de Cardiología, Universidad CES; PUL.SOS. Medellín, Colombia
Syncope is a condition characterized by a sudden and temporary loss of consciousness, caused by decreased blood flow to the brain. It is characterized by rapid onset and short duration (from a few seconds to a minute) and complete spontaneous recovery, with a cumulative lifetime incidence of approximately 35%. Syncope accounts for 0.6-3% of all emergency department visits worldwide. Approximately, 50% of these are admitted. Among the various types of syncope, vasovagal syncope, also known as neurocardiogenic syncope, is the most frequent cause of syncope and is a common reason for emergency department visits, resulting in significant distress and negatively impacting patients’ quality of life, with costly testing and hospital admissions. Improved guidelines and innovative diagnostic approaches, potentially complemented by technology, may offer avenues for more cost-effective and efficient care. A standardised approach to syncope assessment reduces hospital admissions and medical costs and increases diagnostic accuracy. Initial assessment of all patients presenting with syncope includes a detailed history, physical examination and electrocardiogram, which can diagnose up to 50% of patients and allows prompt treatment and risk stratification. Laboratory tests and neuroimaging have a low diagnostic yield and should be ordered only if clinically indicated. Low-risk patients with a single episode of syncope can often be reassured without the need for further investigations. High-risk patients with cardiovascular disease, a history of arrhythmia, abnormal electrocardiographic findings or severe comorbidities should be admitted to hospital for further assessment.
Keywords: Syncope. Tilt table. Arrhythmia.
