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European Heart Journal Advance Access originally published online on November 4, 2005
European Heart Journal 2006 27(1):7-9; doi:10.1093/eurheartj/ehi626
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Syncope Management Guidelines at work: first steps towards assessing clinical utility

David G. Benditt*

Cardiac Arrhythmia Center, University of Minnesota Medical School, MMC 508, 420 Delaware St SE, Minneapolis, MN, USA

* Corresponding author. Tel: +1 612 625 4401; fax: +1 612 624 4937. E-mail address: bendi001@umn.edu

This editorial refers to ‘Hospital admission of patients referred to the Emergency Department for syncope: a single-hospital prospective study based on the application of the European Society of Cardiology Guidelines on syncope’{dagger} by A. Bartoletti et al., on page 83 and ‘A new management of syncope. Prospective systematic guideline-based evaluation of patients referred urgently to general hospitals’{ddagger} by M. Brignole et al., on page 76

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

Management of patients who present after an apparent transient loss of consciousness (TLOC) and who are suspected of having had true syncope remains a clinical challenge; one that is often first confronted by emergency department (ED) and hospital-based physicians. As a first step in assessment of these patients, it is essential that other conditions associated with real (e.g. seizures and concussion) or apparent (e.g. narcolepsy and certain psychogenic disturbances) TLOC, but that are not syncope, be excluded. Syncope refers specifically to TLOC caused by self-limited inadequacy of cerebral perfusion.1,2 Thereafter, attention must be directed towards establishing the most probable cause for syncope; only then can an appropriate treatment strategy be developed.1,3

In terms of TLOC in general, and ‘true syncope’ in particular, conventional diagnostic strategies have long been fraught with confusing terminology,2 incomplete history taking, and inappropriate reliance on excessive laboratory tests; the outcome has been costly with poor diagnostic . . . [Full Text of this Article]

Which syncope patients require in-hospital evaluation?

Can guidelines-directed care enhance syncope management in general hospitals?

What is missing?

Summary

Acknowledgement


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Related articles in EHJ:

A new management of syncope: prospective systematic guideline-based evaluation of patients referred urgently to general hospitals
Michele Brignole, Carlo Menozzi, Angelo Bartoletti, Franco Giada, Alfonso Lagi, Andrea Ungar, Irene Ponassi, Chiara Mussi, Roberto Maggi, Giuseppe Re, Raffaello Furlan, Gianni Rovelli, Patrizia Ponzi, Alessandro Scivales, and for the Evaluation of Guidelines in Syncope Study 2 (EGSYS-2) group
EHJ 2006 27: 76-82. [Abstract] [Full Text]  

Hospital admission of patients referred to the Emergency Department for syncope: a single-hospital prospective study based on the application of the European Society of Cardiology Guidelines on syncope
Angelo Bartoletti, Plinio Fabiani, Paolo Adriani, Francesca Baccetti, Luciano Bagnoli, Gianluca Buffini, Carlo Cappelletti, Paolo Cecchini, Roberto Gianni, Alessandro Lavacchi, Pier Francesco Ticali, and Giovanni Maria Santoro
EHJ 2006 27: 83-88. [Abstract] [Full Text]  



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J Am Coll CardiolHome page
M. Brignole and W. K. Shen
Syncope Management From Emergency Department to Hospital
J. Am. Coll. Cardiol., January 22, 2008; 51(3): 284 - 287.
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