Management of Syncope in Adults: An Update

November 2008
Mayo Clinic Proceedings;Nov2008, Vol. 83 Issue 11, p1280
Academic Journal
Syncope is a clinical syndrome characterized by transient loss of consciousness and postural tone that is most often due to temporary and spontaneously self-terminating global cerebral hypoperfusion. A common presenting problem to health care systems, the management of syncope imposes a considerable socioeconomic burden. Clinical guidelines, such as the European Society of Cardiology Guidelines on Management of Syncope, have helped to streamline its management. In recent years, we have witnessed intensive efforts on many fronts to Improve the evaluation process and to explore therapeutic options. For this update, we summarized recent active research In the following areas: the role of the syncope management unit and risk prediction rules in providing high-quality and cost-effective evaluation In the emergency department, the Implementation of structured history taking and standardized guideline-based evaluation to improve diagnostic yield, the evolving role of the implantable loop recorder as a diagnostic test for unexplained syncope and for guiding management of neurally mediated syncope, and the shift toward non-pharmacological therapies as mainstay treatment for patients with neurally mediated syncope. Syncope is a multidisciplinary problem; future efforts to address critical issues, Including the publication of clinical guidelines, should adopt a multidisciplinary approach.


Related Articles

  • New ESC guideline changes definition of syncope.  // Medical Device Daily;9/7/2009, p2 

    The article reports that the definition of syncope has been changed by the European Society of Cardiology (ESC). According to the 2009 ESC Guidelines for the Diagnosis and Management of Syncope, syncope is a transient loss of consciousness caused by transient global cerebral hypoperfusion that...

  • Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to a general hospital: the EGSYS score. Del Rosso, A.; Ungar, A.; Maggi, R.; Giada, F.; Petix, N. A.; De Santo, T.; Menozzi, C.; Brignole, M. // Heart;Dec2008, Vol. 94 Issue 12, p1620 

    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...

  • fainting painting. Smith, Philip E. M. // Practical Neurology;Dec2005, Vol. 5 Issue 6, p366 

    The article provides information pertaining to fainting or syncope. Fainting is the temporary loss of consciousness and posture due to impaired cerebral perfusion. Vasovagal syncope, the commonest form, typically is situational with specific triggers. Vasovagal syncope is generally benign, but...

  • Symptoms and signs of syncope: a review of the link between physiology and clinical clues. Wieling, Wouter; Thijs, Roland D.; Van Dijk, N.; Wilde, Arthur A. M.; Benditt, David G.; Van Dijk, J. Gert // Brain: A Journal of Neurology;Oct2009, Vol. 132 Issue 10, p2630 

    Detailed history taking is of paramount importance to establish a reliable diagnosis in patients with transient loss of consciousness. In this article the clinical symptoms and signs of the successive phases of a syncopal episode are reviewed. A failure of the systemic circulation to perfuse the...

  • Lower 24 hour urinary sodium concentrations are associated with more severe symptoms in subjects with vasovagal syncope. Hampton, J. L.; Parry, S. W.; Kenny, R. A.; Newton, J. L. // Heart;Jun2004, Vol. 90 Issue 6, p687 

    Vasovagal syncope (VVS) is a common cause of syncope characterised by hypotension, with or without bradycardia, which results in cerebral hypoperfusion and resultant collapse with loss of consciousness. One of the main triggers for VVS is venous pooling in the lower limbs and relative central...

  • The semiology of tilt-induced reflex syncope in relation to electroencephalographic changes. van Dijk, J. Gert; Thijs, Roland D.; van Zwet, Erik; Tannemaat, Martijn R.; van Niekerk, Julius; Benditt, David G.; Wieling, Wouter // Brain: A Journal of Neurology;Feb2014, Vol. 137 Issue 2, p576 

    The neural origins of distinct neurological features of syncope are unclear. Van Dijk et al. study 69 cases of tilt-induced syncope, and find that roving eye movements and stertorous breathing can occur when the EEG is flat. In contrast, myoclonic jerks are abolished by EEG flattening.Syncope is...

  • A simple fix for vasovagal syncope? Pinkowish, Mary Desmond // Patient Care;Jan2003, Vol. 37 Issue 1, p75 

    Discusses research being done on the clinical management of vasovagal syncope. Reference to a study by C. T. Krediet et al, published in the 2002 issue of "Circulation"; Effect of vasovagal reflex syncope on the quality of life of patients; Importance of muscle tensing to the treatment of the...

  • Tilt-induced cardioinhibitory syncope: a follow-up study in 16 patients. Guaraldi, Pietro; Calandra-Buonaura, Giovanna; Terlizzi, Rossana; Cecere, Annagrazia; Solieri, Laura; Barletta, Giorgio; Cortelli, Pietro // Clinical Autonomic Research;Jun2012, Vol. 22 Issue 3, p155 

    Introduction: The exact clinical and prognostic significance and the therapeutic implications of asystole induced by head-up tilt test are still a matter of debate. Methods: We assessed, by means of a semi-structured interview, the long-term outcome of cardioinhibitory syncope in all the...

  • Heart Health: Ask Dr. Zipes.  // Saturday Evening Post;Mar/Apr2008, Vol. 280 Issue 2, p14 

    The article offers questions and answers about heart health and medical issues. One reader asks about vasovagal syncope, or fainting spells, and its causes. Another asks about problems with angina and its treatment. A person asks about hypotension syndrome and the possibility that it might be...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics