PMID: 9182479Jun 15, 1997Paper

Diagnosing syncope. Part 1: Value of history, physical examination, and electrocardiography. Clinical Efficacy Assessment Project of the American College of Physicians

Annals of Internal Medicine
M LinzerW N Kapoor

Abstract

To review the literature on diagnostic testing in syncope and provide recommendations for a comprehensive, cost-effective approach to establishing its cause. Studies were identified through a MEDLINE search (1980 to present) and a manual review of bibliographies of identified articles. Papers were eligible if they addressed diagnostic testing in syncope or near syncope and reported results for at least 10 patients. The usefulness of tests was assessed by calculating diagnostic yield: the number of patients with diagnostically positive test results divided by the number of patients tested or, in the case of monitoring studies, the sum of true-positive and true-negative test results divided by the number of patients tested. Despite the absence of a diagnostic gold standard and the paucity of data from randomized trials, several points emerge. First, history, physical examination, and electrocardiography are the core of the syncope workup (combined diagnostic yield, 50%). Second, neurologic testing is rarely helpful unless additional neurologic signs or symptoms are present (diagnostic yield of electroencephalography, computed tomography, and Doppler ultrasonography, 2% to 6%). Third, patients in whom heart disease is known or sus...Continue Reading

Citations

Oct 30, 1998·Hospital Practice·T P ArcherE L Mazzaferri
Oct 31, 2000·Critical Care Medicine·D J Heaven, R Sutton
Jul 4, 2001·Circulation·B Olshansky
Sep 18, 2001·Health Affairs·E C Becher, M R Chassin
Apr 11, 2002·The Nurse Practitioner·Jonathan F EschedorEvelyn Duffy
Sep 20, 2002·The New England Journal of Medicine·Elpidoforos S SoteriadesDaniel Levy
Jan 29, 2005·Emergency Medicine Australasia : EMA·Rosslyn Hing, Roger Harris
Jan 15, 2005·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Koichi MizumakiHiroshi Inoue
Nov 23, 2006·Internal and Emergency Medicine·Nikhil GoyalRonny Otero
Mar 23, 2007·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Sachin SudAndrew D Krahn
Mar 15, 2008·Critical Pathways in Cardiology·Eyal HerzogJonathan S Steinberg
Aug 12, 2008·Journal of Cardiovascular Electrophysiology·Deviprasad VenugopalDavid G Benditt
Nov 29, 2008·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Frances McCarthyUNKNOWN European Society of Cardiology
May 1, 2006·Future Cardiology·Ehab A Eltahawy, Blair P Grubb
Sep 2, 2009·Circulation·Dan SorajjaWin-Kuang Shen
Feb 15, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Peter MitroPavol Murín
Oct 8, 2014·Journal of Intensive Care Medicine·Jordan C RayNora Goldschlager
Dec 10, 2015·Emergency Medicine International·Hamid KarimanMehdi Pishgahi
May 8, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Alan GarciaJorge Gomez-Flores
Aug 14, 2020·Curēus·Harpreet K RaiMaria Anton
Nov 26, 1999·Journal of General Internal Medicine·W S GetchellJ H McAnulty
Apr 25, 2003·Pacing and Clinical Electrophysiology : PACE·Masaru SuzukiNaoki Aikawa
Aug 10, 2002·Current Cardiology Reports·Satish R Raj, Robert S Sheldon
Dec 5, 2006·Current Opinion in Cardiology·Peter A SmarsWin-Kuang Shen
Sep 20, 2002·The New England Journal of Medicine·William H Maisel, William G Stevenson
Jul 26, 2006·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Michele BrignoleUNKNOWN Evaluation of Guidelines in Syncope Study 2 ( EGSYS-2) GROUP
Nov 15, 2006·Pacing and Clinical Electrophysiology : PACE·Takeki SuzukiShun Kohsaka
Oct 28, 2006·Current Sports Medicine Reports·Balakrishnan Natarajan, Vineet Nikore
Mar 11, 2005·The New England Journal of Medicine·Blair P Grubb
Jun 14, 2003·The Neurologist·Horacio Kaufmann, Kirsty Bhattacharya
Oct 14, 2004·Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society·Horacio Kaufmann, Wouter Wieling
Mar 25, 2008·Critical Care Nursing Quarterly·Barbara A Bentz
Dec 16, 2005·Current Opinion in Cardiology·Paul A GouldLorne J Gula
Jul 10, 2007·The American Journal of Geriatric Cardiology·Oleg RoussanovNabil Jarmukli
Dec 18, 2009·Pacing and Clinical Electrophysiology : PACE·Robert E EckartEric A Shry
Jan 20, 2011·Journal of Paediatrics and Child Health·Sanne DietzWilliam P Whitehouse
Jun 17, 2010·Irish Journal of Medical Science·F McCarthyC J Cunningham
Jul 1, 2011·Journal of Primary Care & Community Health·Marcos DaccarettMohamed H Hamdan
Jan 20, 2015·International Journal of Stroke : Official Journal of the International Stroke Society·James E Siegler, Sheryl Martin-Schild

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.