Description

Shen and Gersh listed risk factors that can distinguish high from low risk syncope. This can help identify patients who may benefit from closer monitoring and more aggressive management. The authors are from the Mayo Clinic and Georgetown Medical Center.


 

Parameters:

(1) age

(2) heart disease

(3) electrocardiogram

(4) resultant injuries

(5) onset

 

Parameter

High Risk Syncope

Low Risk Syncope

age

older

younger

heart disease

present (see below)

absent

electrocardiogram

abnormal (see below)

normal

resultant injuries

serious

none or minor

onset

abrupt with little or no warning; palpitations; after exertion or emotional upset

vasovagal cause

 

Heart disease associated with high risk syncope:

(1) coronary artery disease

(2) history of acute myocardial infarction

(3) structural disease (aortic stenosis, cardiomyopathy, etc., page 654)

(4) left ventricular dysfunction

(5) congestive heart failure

 

Electrocardiogram findings suggesting high risk:

(1) presence of Q wave

(2) bundle branch block

(3) atrial fibrillation

(4) abnormal signal weighted ECG

(5) ventricular arrhythmias

 


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