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A simple algorithm improved physicians' diagnostic performance for patients presenting with syncope

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 QUESTION: In patients presenting to the emergency department (ED) with syncope, what are the relative frequencies of different causes?


2 month cohort study.


9 community hospitals in Italy.


195 patients who were >12 years of age (mean age 63 y, 56% women) and presented to the ED with syncope (sudden transient loss of consciousness and of postural tone with spontaneous recovery). Patients with a known seizure disorder with a prolonged postictal recovery phase or those without a clear loss of consciousness were excluded. Follow up was complete.

Diagnostic strategy

A 2 step diagnostic algorithm was applied to all patients. The first step consisted of a history and physical examination, 12 lead electrocardiogram …

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  • Source of funding: not stated.

  • For correspondence: Dr F Ammirati, Dipartimento delle Malattie del Cuore, Ospedale S. Filippo Neri, Via Attilio Friggeri, 95, 00136 Rome, Italy.