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Score of Sheldon et al for Distinguishing Vasovagal Syncope from Other Syncopal Conditions

Purpose: To evaluate a patient with syncope using the score of Sheldon et al.

Description

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.


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Specialty

Objective

ICD-10