Background: More than two million people are evaluated for syncope each year in the United States, and approximately 30-40% of these patients are hospitalized for further costly investigation. Total annual cost of syncope related hospital evaluation is estimated to be over 2 billion dollars. The most common cause of syncope is reflex mediated. It does [...]

Background: The approach to managing and admitting patients with syncope in an emergency setting lacks standardization. Our study aims to investigate how regional variation in management of emergency department (ED) patients presenting with syncope impacts outcomes and resource utilization in this patient population. Methods: We used the 2006 to 2014 Nationwide Emergency Department Sample to [...]

Background: Syncope scores San Francisco Syncope Rule (SFSR) and Evaluation of Guidelines in Syncope Study (EGSYS)(1) are used as screening tools for predicting adverse outcomes among patient with syncope(1, 2). Surprisingly for scoring systems used for risk stratification of same clinical condition, differ significantly based on variables of importance used in calculating individual scores. An [...]

Background: Syncope is usually an isolated occurrence in younger patients whereas it is multi factorial with many predisposing factors in the elderly. Medication use, co-morbidities and functional decline further complicate syncope evaluation in the elderly. Hence, elderly patients presenting with syncope must be risk stratified uniquely. San Francisco Syncope Rule (SFSR) and Evaluation of Guidelines [...]

Background: Unnecessary hospitalizations and testing for syncope remain common (1), and physician attitudes continue to favor overuse for syncope (2). Structured protocols, specialized units, and decision support algorithms may reduce health service use, but lack of data precludes the ability to advocate for use of a specific decision support algorithm (3). Purpose: Our primary aim [...]

Case Presentation: Patient is a 64 male with a past medical history of coronary artery disease who was experiencing two months of syncopal episodes with increasing frequency. Associated with these episodes were instances where he would wake up at night, face flushed and diaphoretic. He would also note bradycardia to the 30’s. He had an [...]

Case Presentation: A 61-year-old female with a past medical history significant for hypertension well controlled on carvedilol and left elbow fracture status post fixation 2.5 weeks prior presented to the hospital secondary to lightheadedness. Patient had been experiencing waxing and waning lightheadedness for 3 days, worse when standing from the seated position and walking. She [...]