Manejo diagnóstico del síncope en urgencias

Abstract

Syncope is a very common cause for consultation in emergency departments (EDs). Therefore, identifying patients who present criteria for considering it to be high risk is fundamental for proper management. Most of the causes are benign, with neurally mediated syncope and orthostatic hypotension representing the largest proportion of cases seen in EDs. Syncope due to cardiac causes, generally secondary to arrhythmias and aortic stenosis, is more common in the older adult population. In an assessment, it must be confirmed if there was a transient loss of consciousness, if its origin is syncopal or not, and consider if there is an etiological diagnosis. A physical examination and ECG must be performed on all patients. Based on the results and the case history, other additional tests can be proposed, such as a blood test, echocardiogram, carotid sinus massage, or prolonged monitoring.