Format

Send to

Choose Destination
Heart. 2002 Oct;88(4):363-7.

Role of echocardiography in the evaluation of syncope: a prospective study.

Author information

1
Department of Internal Medicine, Hôpital Cantonal, University of Geneva Medical School, Geneva, Switzerland. francois.sarasin@hcuge.ch

Abstract

OBJECTIVE:

To study the role of echocardiography in the stepwise evaluation of syncope.

DESIGN:

A prospective observational study with an 18 month follow up.

SETTING:

University teaching hospital providing primary and tertiary care.

SUBJECTS:

650 consecutive patients with syncope and clinical suspicion of an obstructive valvar lesion, or with syncope not explained by history, physical examination, or a 12 lead ECG, who underwent bidimensional Doppler transthoracic echocardiography.

MAIN OUTCOME MEASURES:

The causes of syncope were assigned using published diagnostic criteria. Echocardiography was considered diagnostic when confirming a suspected diagnosis, or when revealing occult cardiac disease explaining the syncope.

RESULTS:

A systolic murmur was identified in 61 of the 650 patients (9%). Severe aortic stenosis was suspected in 20 of these and was confirmed by echocardiography in eight. Follow up excluded further cases of aortic stenosis. In patients with unexplained syncope (n = 155), routine echocardiography showed no abnormalities that established the cause of the syncope. Echocardiography was normal or non-relevant in all patients with a negative cardiac history and a normal ECG (n = 67). In patients with a positive cardiac history or an abnormal ECG (n = 88), echocardiography showed systolic dysfunction (left ventricular ejection fraction < or = 40%) in 24 (27%) and minor non-relevant findings in the remaining 64. Arrhythmias were diagnosed in 12 of the 24 patients with systolic dysfunction (50%), and in 12 of the 64 remaining patients (19%) (p < 0.01).

CONCLUSIONS:

Echocardiography was most useful for assessing the severity of the underlying cardiac disease and for risk stratification in patients with unexplained syncope but with a positive cardiac history or an abnormal ECG.

PMID:
12231593
PMCID:
PMC1767372
DOI:
10.1136/heart.88.4.363
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center