Signs and symptoms that are predictors for a cardiac cause of syncope or a cardiac arrhythmic cause:
M1: multivariable for del Rosso (2008)63
M2: multivariable for Alboni (2001) heart disease patients6
M3: multivariable for Alboni (2001) without heart disease6
M4: multivariable for Alboni (2001) all patients excluding non-syncope risk factors6
M5: multivariable for Sarasin (2003) in patients with unexplained syncope190
SU and GU: strong and good univariate predictors
Card and cardiac: predictors for cardiac cause; Arr_C: arrhythmic causes
  • Age 65 years and older, but some heterogeneity
    • Arrhythmic syncope (M5 – low and U moderate; same study)
    • Cardiac syncope - age as a continuous variable (GU – low)
    • Cardiac syncope - age 65 years and older (U (weak) – moderate quality; same study as M1 below)
    • But, cardiac syncope - age 65 years and older (2 studies: M4 and M1, not significant, but no results – very low/low)
  • Time between first and last TLoC less than 4 years (in subgroup with suspected/diagnosed heart disease – cardiac; M2 - low )
  • Syncope while supine; Cardiac syncope (borderline GU; 2 studies – low; M1 – moderate (same study as one of GU studies))
    • Also significant in multivariable analysis in subgroup of people with suspected/diagnosed heart disease (M2 – low)
  • Syncope during effort, but some heterogeneity – Cardiac syncope
    • Significant in two studies (SU – low; M1 – moderate (same study as one of SU studies),
    • Not significant in multivariable analysis in people with suspected/diagnosed heart disease in a third study (M2 - no results reported – very low)
  • Blurred vision pre-TLoC; Cardiac syncope in subgroup of people with suspected/diagnosed heart disease (M2 – very low)
  • Palpitations pre-TLoC, gross heterogeneity; Cardiac syncope – very low
    • 2 studies, both univariate; one not significant (same study as M4), one GU
    • only significant predictor for cardiac syncope in people without suspected/diagnosed heart disease (M2 – subgroup of M4)

From: 3, Initial assessment and diagnosis of people who had TLoC

Cover of Transient Loss of Consciousness (‘Blackouts’) Management in Adults and Young People
Transient Loss of Consciousness (‘Blackouts’) Management in Adults and Young People [Internet].
NICE Clinical Guidelines, No. 109.
National Clinical Guideline Centre for Acute and Chronic Conditions (UK).
Copyright © National Clinical Guideline Centre for Acute and Chronic Conditions, 2010.

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