Syncope (2007)

October 16, 2018 by Rob Beatty, MD FACEP

Inclusion: Adult
Exclusion: Children or for patients whom episode of syncope is thought to be secondary to another disease process
Level A:
- History and PE consistent with heart failure help identify patients at high risk for an adverse outcome.
- Standard 12-lead ECG
Level B:
- High risk of AE: Older age, structural heart disease, history of CAD
- Low risk of AE: younger, nonexertional, with out history of or signs of CVD or family history of sudden death and with out co-morbidities
- Admit patients with syncope and evidence of heart failure or structural heart disease
- Admit patients with syncope and other factors that lead to stratification as high-risk for adverse outcomes.
  - Older age and associated co-morbidities
  - Abnormal ECG (Acute ischemia, dysrhythmia, or significant conduction abnormalities)
  - HCT < 30 (if obtained)
  - History or presence of heart failure, CAD< or structural heart disease
Level C:
- Lab testing and advanced investigative testing such as echo or cranial CT need not be routinely performed unless guided by specific findings in the History and PE.

Clinical Policy: Critical issues in the evaluation and management of adult patients presenting to the emergency department with syncope. Ann Emerg Med. 2007;49:431-444

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