Article Text

Download PDFPDF
A standardised sequential clinical examination identified probable causes of syncope in 69% of patients

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

 QUESTION: What are the causes of syncope in patients presenting to the emergency department (ED)?


18 month cohort study.


The ED and inpatient services of a major primary and tertiary care hospital in Geneva, Switzerland.


788 consecutive patients ≥ 18 years of age who presented to the ED with a chief symptom of syncope. Patients with symptoms clearly compatible with seizure disorders, vertigo, dizziness, coma, or shock were excluded. 650 patients (82%) were included in the analysis (mean age 60 y, 52% women).

Diagnostic strategy

All patients had a standardised evaluation that included a complete history, physical, and neurological examination; laboratory examination (haematocrit and serum concentrations of creatine kinase and glucose); 12 lead electrocardiogram (ECG); testing for orthostatic hypotension; and bilateral carotid massage in patients …

View Full Text


  • Source of funding: Swiss National Research Foundation.

  • For correspondence: Dr F P Sarasin, Hôpital Cantonal, Geneva, Switzerland. francois.sarasin{at}