Document Detail

Role of echocardiography in the evaluation of syncope: a prospective study.
MedLine Citation:
PMID:  12231593     Owner:  NLM     Status:  MEDLINE    
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.
F P Sarasin; A-F Junod; D Carballo; S Slama; P-F Unger; M Louis-Simonet
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  88     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-09-16     Completed Date:  2002-10-28     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  363-7     Citation Subset:  AIM; IM    
Department of Internal Medicine, Hôpital Cantonal, University of Geneva Medical School, Geneva, Switzerland.
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MeSH Terms
Follow-Up Studies
Heart Diseases / complications,  ultrasonography*
Prospective Studies
Syncope / etiology,  ultrasonography*
Comment In:
ACP J Club. 2003 May-Jun;138(3):83   [PMID:  12725638 ]

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