Abstract
Structural heart disease is the most important risk factor for mortality in patients with syncope. A workup that includes a thorough history taking, focused physical examination, and electrocardiography yields a diagnosis in nearly half of cases. Echocardiography is indicated in patients with syncope who have a history of cardiac abnormality, abnormal ECG findings, or unexplained syncope. Tilt-table testing and the implantable loop recorder are useful in patients with recurrent syncope of unclear origin. α-Agonists and selective serotonin reuptake inhibitors are the most effective agents for treating neurocardiogenic syncope. Patients with orthostatic syncope require aggressive hydration and a workup for autonomic insufficiency and, in selected patients, adrenal insufficiency. Implantable cardioverter-defibrillators are indicated in specific forms of cardiogenic syncope. Refer patients with unexplained syncope and suspected structural heart disease and/or negative tilt-table testing and/or abnormal findings on implanted loop recording to a specialist.
Original language | English (US) |
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Pages (from-to) | 717-723 |
Number of pages | 7 |
Journal | Consultant |
Volume | 46 |
Issue number | 7 |
State | Published - Jun 2006 |
Externally published | Yes |
Keywords
- Electrocardiography
- Fainting
- Orthostatic hypotension
- Syncope
- Tilt-table test
ASJC Scopus subject areas
- General Medicine