Evaluation of Syncope in the Emergency Department
Introduction Syncope is a symptom complex composed of a transient loss of consciousness associated with an inability to maintain postural tone, secondary to a brief decrease in cerebral blood flow that spontaneously and completely resolves and that requires no resuscitation.1 Accounting for 3% of emergency department (ED) visits and 1% to 6% of all hospital admissions,2 syncope presents a challenge to emergency practitioners: to differentiate those patients safe for discharge from those who require emergent evaluation and in-hospital management for potentially life-threatening etiologies. The precise cause of syncope can be identified during the initial evaluation in only 20% to 50% of patients.3 Of note, it is estimated that up to 80% of the causes of syncope that are identified during a hospital admission are determined in the emergency department.