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Echocardiography was useful in evaluating unexplained syncope

Key Words: syncope • echocardiography • heart diseases

The first 150 words of the full text of this article appear below.

Design
18 month cohort study.

Setting
Emergency department (ED) and inpatient services of a university hospital in Geneva, Switzerland.

Patients
650 consecutive patients who were 18 years of age (mean age 60 y, 54% women) and presented to the ED with the main symptom of syncope (sudden loss of consciousness and of postural tone with spontaneous recovery). Follow up was 95% at 18 months.

Diagnostic strategy
The initial diagnostic workup included a standardised clinical evaluation; baseline laboratory tests; 12 lead electrocardiography (ECG); and testing for orthostatic hypotension. Selected additional testing was done based on abnormal findings after the initial workup. Patients in whom the cause of syncope remained undetermined received serial cardiovascular diagnostic tests: bidimensional Doppler transthoracic echocardiography, bilateral carotid sinus massage, prolonged monitoring with ECG, and passive upright tilt testing. Electrophysiological studies were done on the basis of current recommendations. Echocardiography findings considered to be diagnostic of syncope were severe aortic stenosis, hypertrophic cardiomyopathy . . . [Full text of this article]

Theodore J Kolias, MD

University of Michigan
Ann Arbor, Michigan, USA