When possible, we provide therapeutic and decision-making algorithms.įinally, we recognize that one major challenge in syncope management is the reduction of inappropriate admissions and inappropriate use of tests while maintaining the safety of the patient. For this purpose, even in the absence of strong evidence from trials, we give as much advice as possible on the most appropriate therapy based on the practical expertise of the members of the Task Force (‘Our patients seek solutions, not only explanations’).

The document aims to be patient-orientated and focused on therapy, and to reduce the risk of recurrence and the life-threatening consequences of syncope recurrence. While the print text mainly aims to give formal evidence-based recommendations according to the standardized rules of the ESC, this new web-only feature allows expansion of the content to practical issues, and aims to fill the gap between the best available scientific evidence and the need for dissemination of these concepts into clinical practice (‘We have the knowledge, we need to teach it’). Thanks to the Supplementary Data further explanation on specific points is given, and thanks to the Web Practical Instructions advice is given on how to evaluate patients with loss of consciousness (LOC), and how to perform and interpret tests properly whenever possible, we provide tracings, videos, flow charts, and checklists. The following are some excerpts from Resource (1):Ĭompared with the previous versions of these Guidelines, the 2018 document contains Supplementary Data as an integral part.

Resources (1) through (4) provide the best framework for the evaluation of syncope that I have seen.

Thus, careful evaluation of syncope is critical to prevention of the tragedy of sudden death no matter what your practice setting is. Just as TIA can be a warning of an increased risk of stroke, so can syncope be a warning sign of an increased risk of sudden death. Primary care physicians in many practice settings (office, urgent care, and emergency department) may all be called upon to evaluate syncope. I find that creating these posts really helps me fix the subject in my mind and helps me when I want to do a rapid review. This post is just my study notes (my peripheral brain) on the evaluation of syncope.

Snagit 2018 gradient fill