Evaluation of Syncope: An Overview

Syncope is defined as a sudden temporary loss of consciousness associated with a loss of postural tone, with spontaneous recovery that does not require electrical or chemical cardioversion. Syncope is a common symptom, accounting for 1% to 6% of hospital admission and up to 3% of emergency room visits. Loss of consciousness is also common in healthy young adults, although most do not seek medical attention. Syncope is a frequent symptom in the elderly. The evaluation and management of syncope has dramatically changed over the past 15 years. In the early 1980s, several studies showed that the cause of syncope was often not established, and subgroups were identified with high mortality and sudden death rates.1,2 ,3, 4 Later a large number of studies on electrophysiology testing appeared, which led to a better understanding of the roles and limitations of tests in syncope.5,6,7,8 Although tilt table testing started in 1980s, it assumed an important role in the evaluation of syncope in 1990s, showing that neurally mediated mechanism is a common etiology of unexplained syncope.9,10,11,12 The purpose of this article is to highlight the clinical approach and management of syncope