For the diagnosis of reflex syncope, diligent history-building with the patient and a witness is required. In the Emergency Department (ED), the assessment of syncope is a challenge which may be addressed by an ED Observation Unit or by a referral to a Syncope Unit. Hospital admission is necessary for those with life-threatening cardiac conditions although risk stratification remains an unsolve...

OBJECTIVE To develop, in patients referred for syncope to an emergency department (ED), a diagnostic score to identify those patients likely to have a cardiac cause. DESIGN Prospective cohort study. SETTING ED of 14 general hospitals. PATIENTS 516 consecutive patients with unexplained syncope. INTERVENTIONS Subjects underwent a diagnostic evaluation on adherence to Guidelines of the Eur...

Background: Long QT syndrome (LQTS) is characterized by the prolongation of QT interval, which results in syncope and sudden cardiac death in young people. KCNQ1 is the most common gene responsible for this syndrome. Methods: Molecular investigation was performed by DNA Sanger sequencing in Iranian families with a history of syncope. In silico examinations were performed for predicting the path...

INTRODUCTION Patients with cardiac syncope have a significantly higher mortality than patients with syncope of non-cardiac causes, while patients with syncope of unknown aetiology constitute an intermediate risk group, presumably because this group is mixed, which suggests that further diagnostic testing is warranted. MATERIAL AND METHODS This was a retrospective single-centre study evaluatin...

BACKGROUND The finding of bundle branch block in patients with syncope suggests that paroxysmal AV block may be the cause of syncope, even though its prevalence is unknown. METHODS We evaluated 55 consecutive patients with syncope and bundle branch block (mean age 75 +/- 8 years; median of two syncopal episodes per patient) referred to three Syncope Units. The hierarchy and appropriateness of...

Syncope is a common medical problem, with a frequency between 15% and 39%. In the general population, the annual number episodes are 18.1-39.7 per 1000 patients, with similar incidence between genders. The first report of the incidence of syncope is 6.2 per 1000 person-years. However, there is a significant increase in the incidence of syncope after 70 years of age with rate annual 19.5 per tho...

OBJECTIVE To assess the impact of syncope during sustained ventricular tachycardia on total and cardiac mortality in patients with chronic chagasic heart disease. METHODS We assessed 78 patients with sustained ventricular tachycardia and chronic Chagas' heart disease. The mean age was 53+/-10 years, 45 were males, and the mean ejection fraction was 49.6+/-13%. The patients were divided into 2...

BACKGROUND Due to lack of efficacy in recent trials, current guidelines for the treatment of neurally-mediated (vasovagal) syncope do not promote cardiac pacemaker implantation. However, the finding of asystole during head-up tilt -induced (pre)syncope may lead to excessive cardioinhibitory syncope diagnosis and treatment with cardiac pacemakers as blood pressure is often discontinuously measur...

myxomas, the most common primary cardiac tumors, are known as a source of cardiogenic emboli. the possibility of their early detection has made them of great importance for emergency medicines. detection of the disease is probable at early stages using echocardiography and associate complications such as syncope, cerebral embolic ischemic strokes, and sudden death. we report experience of a rar...

BACKGROUND Previous studies have indicated that the suboptimal performance of the San Francisco Syncope Rule (SFSR) is likely due to the misclassification of the "abnormal electrocardiogram (ECG)" variable. We sought to identify specific emergency department (ED) ECG and cardiac monitor abnormalities that better predict cardiac outcomes within 30 days in adult ED syncope patients. METHODS Thi...