Syncope: A focused approach to the workup and management

Allison B. Ludwig, Sreekanth Vemulapalli, Nora Goldschlager

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)717-723
Number of pages7
JournalConsultant
Volume46
Issue number7
StatePublished - Jun 2006
Externally publishedYes

Fingerprint

Syncope
Heart Diseases
Electrocardiography
Vasovagal Syncope
Adrenal Insufficiency
Implantable Defibrillators
Serotonin Uptake Inhibitors
Physical Examination
Echocardiography
Mortality

Keywords

  • Electrocardiography
  • Fainting
  • Orthostatic hypotension
  • Syncope
  • Tilt-table test

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ludwig, A. B., Vemulapalli, S., & Goldschlager, N. (2006). Syncope: A focused approach to the workup and management. Consultant, 46(7), 717-723.

Syncope : A focused approach to the workup and management. / Ludwig, Allison B.; Vemulapalli, Sreekanth; Goldschlager, Nora.

In: Consultant, Vol. 46, No. 7, 06.2006, p. 717-723.

Research output: Contribution to journalArticle

Ludwig, AB, Vemulapalli, S & Goldschlager, N 2006, 'Syncope: A focused approach to the workup and management', Consultant, vol. 46, no. 7, pp. 717-723.
Ludwig AB, Vemulapalli S, Goldschlager N. Syncope: A focused approach to the workup and management. Consultant. 2006 Jun;46(7):717-723.
Ludwig, Allison B. ; Vemulapalli, Sreekanth ; Goldschlager, Nora. / Syncope : A focused approach to the workup and management. In: Consultant. 2006 ; Vol. 46, No. 7. pp. 717-723.
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