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Syncope: Difference between revisions
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==Clinical features== | ==Clinical features== | ||
History taking is the most important feature in syncope evaluation. After that the following clinical features are suggestive of a specific cause of syncope: | History taking is the most important feature in syncope evaluation. After that the following clinical features are suggestive of a specific cause of syncope: | ||
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|bgcolor="#99FFCC" align="center"|'''Reflex (neurally mediated) syncope''' | |bgcolor="#99FFCC" align="center"|'''Reflex (neurally mediated) syncope''' | ||
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*Family history of sudden death | *Family history of sudden death | ||
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In all patients presenting to a physician with syncope an ECG is recommended to screen for a cardiac cause of syncope. Holter monitoring is indicated only in patients who have very frequent syncopes or presyncope. In-hospital monitoring (in bed or telemetric) is warranted only when the patient has important structural heart disease and is at high risk of life-threatening arrhythmias. | In all patients presenting to a physician with syncope an ECG is recommended to screen for a cardiac cause of syncope. Holter monitoring is indicated only in patients who have very frequent syncopes or presyncope. In-hospital monitoring (in bed or telemetric) is warranted only when the patient has important structural heart disease and is at high risk of life-threatening arrhythmias. | ||
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==References== | ==References== | ||
#The ESC Textbook of Cardiovascular Medicine. Second edition. Editors: Camm AJ, Luscher TF, Serruys PW. 2009. Oxford university press. | #The ESC Textbook of Cardiovascular Medicine. Second edition. Editors: Camm AJ, Luscher TF, Serruys PW. 2009. Oxford university press. | ||
#Freeman R et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 2011; 21:69-72 | #Freeman R et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 2011; 21:69-72 | ||
#Hainsworth R. Pathophysiology of syncope. Clin Auton Res 2004; 14: Suppl 1:18-24 | #Hainsworth R. Pathophysiology of syncope. Clin Auton Res 2004; 14: Suppl 1:18-24 | ||
#Moya A et al. Guidelines for the diagnosis and management of syncope. Eur Heart J 2009; 30:2631-71 | #Moya A et al. Guidelines for the diagnosis and management of syncope. Eur Heart J 2009; 30:2631-71 | ||
#Wieling W et al. Symptoms and signs of syncope: a review of the link between physiology and clinical clues. Brain 2009; 132:2630-42. | #Wieling W et al. Symptoms and signs of syncope: a review of the link between physiology and clinical clues. Brain 2009; 132:2630-42. | ||