Progress in cardiovascular diseases
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Prog Cardiovasc Dis · Jan 2013
ReviewSyncope management unit: evolution of the concept and practice implementation.
Syncope, a clinical syndrome, has many potential causes. The prognosis of a patient experiencing syncope varies from benign outcome to increased risk of mortality or sudden death, determined by the etiology of syncope and the presence of underlying disease. Because a definitive diagnosis often cannot be established immediately, hospital admission is frequently recommended as the "default" approach to ensure patient's safety and an expedited evaluation. ⋯ Similarities and differences of these syncope units are compared. Outcomes and endpoints from these studies are summarized. Developing a syncope unit with a standardized protocol applicable to most practice settings would be an ultimate goal for clinicians and investigators who have interest, expertise, and commitment to improve care for this large patient population.
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Prog Cardiovasc Dis · Jan 2013
ReviewSyncope risk assessment in the emergency department and clinic.
The initial assessment of patients who present with presumed syncope is challenging. Syncope has many possible causes ranging from relatively benign to potentially life-threatening, and sorting through the possibilities may not be feasible given time limitations in an urgent care setting. Therefore, the physician almost always must determine whether the affected individual needs in-hospital evaluation or can be safely referred to an outpatient syncope evaluation clinic. ⋯ In those cases in which the diagnosis is uncertain, risk stratification schemes such as those summarized in this communication become more essential. However, at present no single risk assessment protocol appears to be satisfactory for universal application. The development of a consensus recommendation is an essential next step.