Sheldon et al developed a score for distinguishing vasovagal syncope from syncope due to another cause. The authors are from the University of Calgary, McMaster University and the Wales Heart Institute.
Parameters:
(1) history of certain cardiac arrhythmias and/or diabetes
(2) cynosis (blue color) observed by a bystander
(3) age at first syncopal episode
(4) remembering something about the spell
(5) pre-syncope or syncope with prolonged sitting or standing
(6) sweating or feeling warm prior to a spell
(7) pre-syncope or syncope with pain or a medical procedure
Parameter |
Finding |
Points |
---|---|---|
history |
bifascicular block, asystole, supraventricular tachycardia and/or diabetes |
-5 |
|
none of these |
0 |
cyanosis |
absent |
0 |
|
present |
-4 |
age at first episode |
< 35 years of age |
0 |
|
>= 35 years of age |
-3 |
remembers something |
no |
0 |
|
yes |
-2 |
onset after prolonged sitting or standing |
no |
0 |
|
yes |
1 |
sweating or feeling warm prior to an episode |
no |
0 |
|
yes |
2 |
onset associated with pain or a medical procedure |
no |
0 |
|
yes |
3 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: -14
• maximum score: +6
• A score >= -2 is associated with vasovagal syncope.
• A score from –14 to –3 is associated with a cause other than vasovagal response.
Purpose: To evaluate a patient with syncope using the score of Sheldon et al.
Specialty: Neurology
Objective: differential diagnosis and mimics, red flags
ICD-10: R55,