Abstract
Background: Background Syncope is a frequent problem among patients who present to the ED, accounts for 3% of emergency department admission and 1% of hospitalization. It is characterized by a comparatively short and self-limited loss of consciousness, which is caused by temporary cerebral hypoperfusion. Objective: Therefore, Risk stratification performed in the ED can guide triage decisions, and Risk-stratifying patients into low, moderate, and high-risk groups can assist medical decisions and determine the patient’s disposition. Discussion: The central point of syncope progression pathophysiology is the reduction of systemic blood pressure (BP) with a drop in global cerebral blood flow. Based on the European Society of Cardiology (ESC) syncope practice guidelines, syncope is classified into three categories, Neurally-mediated syncope (neural reflex syncope), Orthostatic hypotension, Cardiac syncope. Proper evaluation of syncope cases could in turn enable timely hospitalization and treatment by syncope experts. Assessment of a patient with syncope can be difficult, requiring a wide variety of medical testing with high health care costs. Sometimes, even after a careful examina- tion, it may not be possible to determine a definitive etiology for syncope. Given these uncertainties, about one-third of emergency room (ER) syncope/collapse patients are referred for assessment to the hospital, including non to low-risk patients. establish the urgency of any further work-up. Conclusion: Syncope assessment and treatment are very difficult, and syncope cases should be treated and dispositioned properly using proper risk stratification guidelines.
Highlights
Syncope is one of the most prevalent conditions in ED patients, comprising 1% of hospital admissions and 3% of referrals to the emergency room.[1]. It is a condition characterized by a spontaneous, self-limited episode of lack of consciousness arising from a sudden disruption of the delivery of oxygen to the brain, which is nearly invariably triggered by a sudden absence of blood flow
Systemic blood pressure (BP) is the product of total peripheral resistance and cardiac output; syncope can result from a fall in either
Management of a syncope patient related to Wolff-Parkinson-White syndrome typically involves catheter ablation, and treatment of a patient with syncope related to Ventricular tachycardia (VT) or in the setting of ischemic or non-ischemic cardiomyopathy may involve implantation of a defibrillator.[23]
Summary
Syncope is one of the most prevalent conditions in ED patients, comprising 1% of hospital admissions and 3% of referrals to the emergency room.[1]. Hospital admission remains a common practice in dealing with syncope. Half of these patients are rehospitalized for further examination; half of which will be released without a convincing diagnosis.[6]. When the cause of symptoms remains unclear after initial evaluation in ED, Assessing the probability of serious implications, such as the risk of major coronary events or sudden cardiac death, is essential. This risk stratification profile will help direct the future treatment and condition of the patient.[7]. Clinical decision making can be challenging in the management of syncope patients admitted to ED.[5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
