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