syncope

Summary

Summary: A transient loss of consciousness and postural tone caused by diminished blood flow to the brain (i.e., BRAIN ISCHEMIA). Presyncope refers to the sensation of lightheadedness and loss of strength that precedes a syncopal event or accompanies an incomplete syncope. (From Adams et al., Principles of Neurology, 6th ed, pp367-9)

Top Publications

  1. Muehlsteff J, Ritz A, Drexel T, Eickholt C, Carvalho P, Couceiro R, et al. Pulse Arrival Time as surrogate for systolic blood pressure changes during impending neurally mediated syncope. Conf Proc IEEE Eng Med Biol Soc. 2012;2012:4283-6 pubmed publisher
    Blood pressure regulation failures cause neurally mediated syncope often resulting in a fall...
  2. Ruwald M, Hansen M, Lamberts M, Kristensen S, Wissenberg M, Olsen A, et al. Accuracy of the ICD-10 discharge diagnosis for syncope. Europace. 2013;15:595-600 pubmed publisher
    ..We assessed the validity of the discharge diagnosis of syncope in administrative registers and reviewed the etiology of syncope after workup.
  3. Güldner S, Langada V, Popp S, Heppner H, Mang H, Christ M. Patients with syncope in a German emergency department: description of patients and processes. Dtsch Arztebl Int. 2012;109:58-65 pubmed publisher
    We studied the characteristics and resource utilization of patients with syncope in a German emergency department (ED).
  4. Thiruganasambandamoorthy V, Hess E, Turko E, Perry J, Wells G, Stiell I. Outcomes in Canadian emergency department syncope patients--are we doing a good job?. J Emerg Med. 2013;44:321-8 pubmed publisher
    Little is known about the outcomes of adults with syncope seen in Canadian Emergency Departments (EDs).
  5. Sun B, Thiruganasambandamoorthy V, Cruz J. Standardized reporting guidelines for emergency department syncope risk-stratification research. Acad Emerg Med. 2012;19:694-702 pubmed publisher
    There is increasing research interest in the risk stratification of emergency department (ED) syncope patients. A major barrier to comparing and synthesizing existing research is wide variation in the conduct and reporting of studies...
  6. Kang G, Oh J, Kim J, On Y, Song H, Jo I, et al. Diagnostic patterns in the evaluation of patients presenting with syncope at the emergency or outpatient department. Yonsei Med J. 2012;53:517-23 pubmed publisher
    Patterns of syncope evaluation vary widely among physicians and hospitals...
  7. Hastings J, Levine B. Syncope in the athletic patient. Prog Cardiovasc Dis. 2012;54:438-44 pubmed publisher
    b>Syncope is a common but concerning event in athletic patients. As such, efforts must be made to distinguish presyncope from syncope with a critical distinction of syncope during exercise and postexercise syncope...
  8. Take Y, Morita H, Toh N, Nishii N, Nagase S, Nakamura K, et al. Identification of high-risk syncope related to ventricular fibrillation in patients with Brugada syndrome. Heart Rhythm. 2012;9:752-9 pubmed publisher
    b>Syncope in patients with Brugada syndrome is usually associated with ventricular tachyarrhythmia, but some episodes of syncope can be related to autonomic disorders.
  9. Sacher F, Arsac F, Wilton S, Derval N, Denis A, de Guillebon M, et al. Syncope in Brugada syndrome patients: prevalence, characteristics, and outcome. Heart Rhythm. 2012;9:1272-9 pubmed publisher
    The report from the 2nd Consensus Committee on BrS suggests that all patients with syncope without a "clear extracardiac cause" should have an implantable cardioverter-defibrillator (ICD)...

More Information

Publications75

  1. Chung C, Cheng C, Zivadinov R, Chen W, Sheng W, Lee Y, et al. Jugular venous reflux and plasma endothelin-1 are associated with cough syncope: a case control pilot study. BMC Neurol. 2013;13:9 pubmed publisher
    Jugular venous reflux (JVR) has been reported to cause cough syncope via retrograde-transmitted venous hypertension and consequently decreased cerebral blood flow (CBF)...
  2. Janczak D, Skóra J, Ruciński A, Szuba A. Recurrent syncope caused by compression of internal carotid artery by an anomalous hyoid bone. Vasa. 2012;41:221-4 pubmed publisher
    In rare cases a syncope can be caused by compression or irritation of the carotid artery and the carotid sinus due to congenital anatomical anomalies of cervical structures like the hyoid bone...
  3. Brignole M, Hamdan M. New concepts in the assessment of syncope. J Am Coll Cardiol. 2012;59:1583-91 pubmed publisher
    ..This paper gives the reader brief guidance on how to manage a patient with syncope, with reference to the above guidelines...
  4. Ruwald M, Hansen M, Lamberts M, Hansen C, Vinther M, Køber L, et al. Prognosis among healthy individuals discharged with a primary diagnosis of syncope. J Am Coll Cardiol. 2013;61:325-32 pubmed publisher
    This study sought to examine the risk of major cardiac adverse events and death in a nationwide cohort of patients without previous comorbidity admitted for syncope.
  5. Ruwald M, Hansen M, Lamberts M, Hansen C, Højgaard M, Køber L, et al. The relation between age, sex, comorbidity, and pharmacotherapy and the risk of syncope: a Danish nationwide study. Europace. 2012;14:1506-14 pubmed
    b>Syncope is a common cause for hospitalization and may be related to comorbidity and concurrent medication...
  6. Goswami N, Roessler A, Hinghofer Szalkay H, Montani J, Steptoe A. Delaying orthostatic syncope with mental challenge: a pilot study. Physiol Behav. 2012;106:569-73 pubmed publisher
    At orthostatic vasovagal syncope there appears to be a sudden decline of sympathetic activity...
  7. Vardas P, Auricchio A, Blanc J, Daubert J, Drexler H, Ector H, et al. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in collaboration with the European Heart Rhythm Association. Eur Heart J. 2007;28:2256-95 pubmed
  8. Hinghofer Szalkay H, Lackner H, Rössler A, Narath B, Jantscher A, Goswami N. Hormonal and plasma volume changes after presyncope. Eur J Clin Invest. 2011;41:1180-5 pubmed publisher
    ..The magnitude of observed concentration changes cannot be explained by haemoconcentration/haemodilution, rather it appears that the observed changes are indicative of hormone-specific endocrine activation patterns in the recovery phase. ..
  9. Christé G, Thériault O, Chahine M, Millat G, Rodriguez Lafrasse C, Rousson R, et al. A new C-terminal hERG mutation A915fs+47X associated with symptomatic LQT2 and auditory-trigger syncope. Heart Rhythm. 2008;5:1577-86 pubmed publisher
    ..hERG (A915fs+47X) was discovered in a 32-year-old woman with torsades de pointes, long QTc interval (515 ms), and syncope upon auditory trigger. We explored whether the properties of this mutation could explain the pathology...
  10. Sud S, Klein G, Skanes A, Gula L, Yee R, Krahn A. Predicting the cause of syncope from clinical history in patients undergoing prolonged monitoring. Heart Rhythm. 2009;6:238-43 pubmed publisher
    b>Syncope may be the result of primary bradycardia or tachycardia, vasovagal syncope, or noncardiac syncope. Risk factors and outcome scores to predict prognosis in patients with syncope have been developed...
  11. Giancaspro G, Suppa M, Genuini I, Caselli S, Fedele F. Syncope caused by iatrogenic hyperkalemia. J Cardiovasc Med (Hagerstown). 2009;10:72-4 pubmed
    ..We report a case of an 87-year-old woman with a clinical history of chronic angiotensin-receptor blocker consumption that led her to dangerous bradyarrhythmia, cardiogenic syncope, and risk of sudden cardiac death.
  12. Sarzi Braga S, Manni R, Pedretti R. Laughter-induced syncope. Lancet. 2005;366:426 pubmed
  13. Coplan N. Carotid sinus hypersensitivity and syncope: cause/effect or true/true/unrelated. Arch Intern Med. 2006;166:491-2 pubmed
  14. Fejerman N. Nonepileptic disorders imitating generalized idiopathic epilepsies. Epilepsia. 2005;46 Suppl 9:80-3 pubmed
    ..myoclonus, apnea and apparent life-threatening events in infants, cyanotic and pallid breath-holding spells, syncope, staring spells, psychogenic seizures, hyperventilation syndrome, and narcolepsy have been selected based on ..
  15. Brignole M, Menozzi C, Bartoletti A, Giada F, Lagi A, Ungar A, et al. A new management of syncope: prospective systematic guideline-based evaluation of patients referred urgently to general hospitals. Eur Heart J. 2006;27:76-82 pubmed
    The guidelines of the European Society of Cardiology (ESC) define the current standard for the management of syncope, but are still incompletely applied in the clinical setting.
  16. Busweiler L, Jardine D, Frampton C, Wieling W. Sleep syncope: important clinical associations with phobia and vagotonia. Sleep Med. 2010;11:929-33 pubmed publisher
    To compare demographic and clinical data from patients with sleep syncope to those of patients with "classical" vasovagal syncope [VVS] collected over the last 8 years.
  17. David J, Yale S, Vidaillet H. Hyperventilation-induced syncope: no need to panic. Clin Med Res. 2003;1:137-9 pubmed
    Accurately diagnosing and treating adult patients presenting with recurrent syncope can be extremely problematic. We present the case of a patient who presented with recurrent syncope...
  18. Claydon V, Hainsworth R. Increased postural sway in control subjects with poor orthostatic tolerance. J Am Coll Cardiol. 2005;46:1309-13 pubmed
    ..This study sought to evaluate postural sway in control subjects with good and poor orthostatic tolerance (OT)...
  19. Schernthaner C, Danmayr F, Altenberger J, Pichler M, Strohmer B. High incidence of tachyarrhythmias detected by an implantable loop recorder in patients with unexplained syncope. Kardiol Pol. 2008;66:37-44; discussion 45-6 pubmed
    b>Syncope is a complex clinical syndrome that may be challenging with respect to a definite diagnosis. The implantable loop recorder (ILR) is a useful tool to define but also to exclude an arrhythmic aetiology.
  20. Rockx M, Hoch J, Klein G, Yee R, Skanes A, Gula L, et al. Is ambulatory monitoring for "community-acquired" syncope economically attractive? A cost-effectiveness analysis of a randomized trial of external loop recorders versus Holter monitoring. Am Heart J. 2005;150:1065 pubmed
    Out patient ambulatory monitoring is often performed in patients with syncope that present in the primary care setting to include or exclude an arrhythmia...
  21. Shukla G, Zimetbaum P. Cardiology patient page. Syncope. Circulation. 2006;113:e715-7 pubmed
  22. van Dijk N, Sprangers M, Colman N, Boer K, Wieling W, Linzer M. Clinical factors associated with quality of life in patients with transient loss of consciousness. J Cardiovasc Electrophysiol. 2006;17:998-1003 pubmed
  23. Yilmaz O, Eser M, Sahiner A, Altintop L, Yesildag O. Hypotension, bradycardia and syncope caused by honey poisoning. Resuscitation. 2006;68:405-8 pubmed
    ..a variety of symptoms including nausea, vomiting, salivation, dizziness, weakness, hypotension, bradycardia and syncope several hours after the ingestion of small amounts of honey...
  24. Grossman S, Babineau M, Burke L, Kancharla A, Mottley L, Nencioni A, et al. Do outcomes of near syncope parallel syncope?. Am J Emerg Med. 2012;30:203-6 pubmed publisher
    Limited information on the evaluation of emergency department (ED) patients complaining of "near syncope" exists...
  25. Chen L, Benditt D, Shen W. Management of syncope in adults: an update. Mayo Clin Proc. 2008;83:1280-93 pubmed publisher
    b>Syncope is a clinical syndrome characterized by transient loss of consciousness and postural tone that is most often due to temporary and spontaneously self-terminating global cerebral hypoperfusion...
  26. Blanc J, L her C, Gosselin G, Cornily J, Fatemi M. Prospective evaluation of an educational programme for physicians involved in the management of syncope. Europace. 2005;7:400-6 pubmed
    Management of patients (pts) presenting syncope diverges markedly from the guidelines of the European Society of Cardiology (ESC). To improve this management, the easiest option seemed to be to educate physicians...
  27. Rassaf T, Muehlsteff J, Such O, Kelm M, Meyer C. The pulse arrival time approach for non-invasive hemodynamic monitoring in low-acuity settings. Med Sci Monit. 2010;16:MT83-7 pubmed
    ..g. pulmonary embolism resulting in syncope) remains a serious problem and an important cause of death...
  28. Schroeder C, Birkenfeld A, Mayer A, Tank J, Diedrich A, Luft F, et al. Norepinephrine transporter inhibition prevents tilt-induced pre-syncope. J Am Coll Cardiol. 2006;48:516-22 pubmed
    ..We tested the hypothesis that pharmacological norepinephrine reuptake transporter (NET) inhibition delays the onset of head-up tilt-induced presyncope in healthy subjects...
  29. Chen Scarabelli C, Kaza A, Scarabelli T. Syncope due to nasopharyngeal carcinoma. Lancet Oncol. 2005;6:347-9 pubmed
  30. Sclafani J, My J, Zacher L, Eckart R. Intensive education on evidence-based evaluation of syncope increases sudden death risk stratification but fails to reduce use of neuroimaging. Arch Intern Med. 2010;170:1150-4 pubmed publisher
    ..We sought to determine whether aggressive education on evidence-based guidelines would affect the use of resources. Specifically, we sought to educate providers about the role of neuroimaging as well as sudden death risk stratification...
  31. Anderson C, Reed M. The influence of temperature and humidity on Emergency Department syncope attendances. Eur J Emerg Med. 2010;17:240-2 pubmed publisher
    The objective of this study was to assess whether the number of syncope attendances to the Emergency Department is related to daily temperature and humidity, or time of the day, day of the week, month or season of the year...
  32. Thiruganasambandamoorthy V, Hess E, Alreesi A, Perry J, Wells G, Stiell I. External validation of the San Francisco Syncope Rule in the Canadian setting. Ann Emerg Med. 2010;55:464-72 pubmed publisher
    b>Syncope is a common disposition challenge for emergency physicians. Among the risk-stratification instruments available, only the San Francisco Syncope Rule is rigorously developed...
  33. Sidik N, Quay C, Loh F, Chen L. Prevalence of Brugada sign and syndrome in patients presenting with arrhythmic symptoms at a Heart Rhythm Clinic in Singapore. Europace. 2009;11:650-6 pubmed publisher
    ..We aimed to determine the prevalence of Brugada sign [Types 1, 2, and 3 Brugada electrocardiogram (ECG)] and syndrome at an arrhythmia clinic in Singapore...
  34. Chen L, Shen W, Mahoney D, Jacobsen S, Rodeheffer R. Prevalence of syncope in a population aged more than 45 years. Am J Med. 2006;119:1088.e1-7 pubmed
    Our current understanding of the prevalence of syncope is based on a few small studies of highly selected populations...
  35. Carrega L, Saadjian A, Mercier L, Zouher I, Berge Lefranc J, Gerolami V, et al. Increased expression of adenosine A2A receptors in patients with spontaneous and head-up-tilt-induced syncope. Heart Rhythm. 2007;4:870-6 pubmed
    Adenosine may play a role in the triggering of neurocardiogenic syncope, but no information on adenosine receptors is available at the present time.
  36. Chao A, Lin R, Liu C, Wang P, Hsu H. Mechanisms of cough syncope as evaluated by valsalva maneuver. Kaohsiung J Med Sci. 2007;23:55-62 pubmed
    Successful treatment of cough syncope depends on the correction of various pathogenetic mechanisms among different patients...
  37. Ribeiro R, Souza N, Carvalho D. Glossopharyngeal neuralgia with syncope as a sign of neck cancer recurrence. Arq Neuropsiquiatr. 2007;65:1233-6 pubmed
    Glossopharyngeal neuralgia with syncope as a sign of neck cancer is a very rare condition. A review of the literature revealed only 29 cases formerly reported. We present the first Brazilian case of such association...
  38. Paul M, Gerss J, Schulze Bahr E, Wichter T, Vahlhaus C, Wilde A, et al. Role of programmed ventricular stimulation in patients with Brugada syndrome: a meta-analysis of worldwide published data. Eur Heart J. 2007;28:2126-33 pubmed
    ..The role of programmed ventricular stimulation (PVS) in risk stratification has been controversially discussed. Therefore, we performed a meta-analysis on the prognostic role of PVS in BS...
  39. Dawn B, Paliwal V, Raza S, Mastali K, Longaker R, Stoddard M. Left ventricular outflow tract obstruction provoked during dobutamine stress echocardiography predicts future chest pain, syncope, and near syncope. Am Heart J. 2005;149:908-16 pubmed
    ..We sought to determine whether dynamic LV outflow tract (LVOT) versus LV midcavitary obstruction provoked during DSE would predict future chest pain, syncope, and/or near syncope.
  40. Bartoletti A, Fabiani P, Adriani P, Baccetti F, Bagnoli L, Buffini G, et al. Hospital admission of patients referred to the Emergency Department for syncope: a single-hospital prospective study based on the application of the European Society of Cardiology Guidelines on syncope. Eur Heart J. 2006;27:83-8 pubmed
    To evaluate the applicability and the clinical impact of the European Society of Cardiology (ESC) Guidelines' recommendations for hospital admission of patients with syncope in a District Hospital Emergency Department (ED).
  41. Kindl T, Hassan A, Booth R, Durham S, Papadimos T. A primary high-grade pleomorphic pericardial liposarcoma presenting as syncope and angina. Anesth Analg. 2006;102:1363-4 pubmed
  42. Nayar S, Nayar P, Cherian K. Angiosarcoma presenting as syncope. Asian Cardiovasc Thorac Ann. 2008;16:154-6 pubmed
    A 31-year-old lady presented with anemia and syncope. Echocardiography revealed massive pericardial effusion with a right atrial mass...
  43. Brignole M, Vardas P, Hoffman E, Huikuri H, Moya A, Ricci R, et al. Indications for the use of diagnostic implantable and external ECG loop recorders. Europace. 2009;11:671-87 pubmed publisher
  44. Edvardsson N, Frykman V, van Mechelen R, Mitro P, Mohii Oskarsson A, Pasquie J, et al. Use of an implantable loop recorder to increase the diagnostic yield in unexplained syncope: results from the PICTURE registry. Europace. 2011;13:262-9 pubmed publisher
    To collect information on the use of the Reveal implantable loop recorder (ILR) in the patient care pathway and to investigate its effectiveness in the diagnosis of unexplained recurrent syncope in everyday clinical practice.
  45. Malasana G, Brignole M, Daccarett M, Sherwood R, Hamdan M. The prevalence and cost of the faint and fall problem in the state of Utah. Pacing Clin Electrophysiol. 2011;34:278-83 pubmed publisher
    ..Understanding the frequency and economic impact of faint and fall is a prerequisite for the creation of cost-effective diagnostic approaches...
  46. Alshekhlee A, Guerch M, Ridha F, McNeeley K, Chelimsky T. Postural tachycardia syndrome with asystole on head-up tilt. Clin Auton Res. 2008;18:36-9 pubmed
    ..We report four patients with POTS, who had long ventricular pauses (i.e. asystole) and syncope during head-up tilt test...
  47. Murrell C, Cotter J, George K, Shave R, Wilson L, Thomas K, et al. Influence of age on syncope following prolonged exercise: differential responses but similar orthostatic intolerance. J Physiol. 2009;587:5959-69 pubmed publisher
    ..stroke volume (SV) were measured continuously whilst supine and during 60 deg head-up tilt for 15 min or to pre-syncope. Orthostatic tolerance was reduced post-exercise (tilt completed (min:s, mean +/- s.d...
  48. van Dijk N, Boer M, De Santo T, Grovale N, Aerts A, Boersma L, et al. Daily, weekly, monthly, and seasonal patterns in the occurrence of vasovagal syncope in an older population. Europace. 2007;9:823-8 pubmed
    ..The aim of this study was to assess the frequency of vasovagal episodes over the day, week, month, and seasons...
  49. Del Rosso A, Alboni P, Brignole M, Menozzi C, Raviele A. Relation of clinical presentation of syncope to the age of patients. Am J Cardiol. 2005;96:1431-5 pubmed
    The aim of the study was to evaluate the effect of patient age on the clinical presentation of syncope and to establish the diagnostic value of clinical history in older patients...
  50. Huff J, Decker W, Quinn J, Perron A, Napoli A, Peeters S, et al. Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with syncope. Ann Emerg Med. 2007;49:431-44 pubmed
  51. Ulas U, Chelimsky T, Chelimsky G, Mandawat A, McNeeley K, Alshekhlee A. Comorbid health conditions in women with syncope. Clin Auton Res. 2010;20:223-7 pubmed publisher
    We determine the comorbid conditions associated with syncope in women. In addition, we hypothesize a higher proportion of autonomic comorbid conditions during the female reproductive age.
  52. Giglio P, Bednarczyk E, Weiss K, Bakshi R. Syncope and head CT scans in the emergency department. Emerg Radiol. 2005;12:44-6 pubmed
    Patients presenting with syncope to the emergency department (ED) of a community hospital were evaluated.
  53. Gill S, Anderson G, Fischer H, Bell C, Li P, Normand S, et al. Syncope and its consequences in patients with dementia receiving cholinesterase inhibitors: a population-based cohort study. Arch Intern Med. 2009;169:867-73 pubmed publisher
    ..These drugs can provoke symptomatic bradycardia and syncope, which may lead to permanent pacemaker insertion...
  54. Inamdar V, Mehta S, Juang G, Cohen T. The utility of implantable loop recorders for diagnosing unexplained syncope in 100 consecutive patients: five-year, single-center experience. J Invasive Cardiol. 2006;18:313-5 pubmed
    The purpose of this study was to retrospectively review the 5-year experience of a university hospital with implantable loop recorders (ILR) for the diagnosis of recurrent, unexplained syncope or presyncope.
  55. Gehi A, Duong T, Metz L, Gomes J, Mehta D. Risk stratification of individuals with the Brugada electrocardiogram: a meta-analysis. J Cardiovasc Electrophysiol. 2006;17:577-83 pubmed
    ..We performed a meta-analysis of prognostic studies of patients with a Brugada ECG to assess predictors of events...
  56. Suzuki T, Matsunaga N, Kohsaka S. Diagnostic patterns in the evaluation of patients hospitalized with syncope. Pacing Clin Electrophysiol. 2006;29:1240-4 pubmed
    b>Syncope accounts for 5% of all hospital admissions. The etiology of syncope varies broadly, and nonselective, inpatient diagnostic evaluations to determine the cause of syncope are often inconclusive...
  57. Goyal N, Donnino M, Vachhani R, Bajwa R, Ahmad T, Otero R. The utility of head computed tomography in the emergency department evaluation of syncope. Intern Emerg Med. 2006;1:148-50 pubmed
    Current guidelines for evaluation of syncope recommend that in the absence of objective focal neurologic findings, head computed tomography (HCT) may not be necessary...
  58. Ellis A, Reed J, Fairbrother D. A tangled affair: pacemaker malfunction and syncope in a child due to Twiddler's syndrome. Cardiol Young. 2007;17:220-2 pubmed
    ..rotated his pacemaker under the skin, knotting the leads and dislodging them from the heart, leading to syncope and heart block...
  59. Ojha A, McNeeley K, Heller E, Alshekhlee A, Chelimsky G, Chelimsky T. Orthostatic syndromes differ in syncope frequency. Am J Med. 2010;123:245-9 pubmed publisher
    There are conflicting opinions on whether postural tachycardia syndrome predisposes to syncope. We investigated this relationship by comparing the frequency of syncope in postural tachycardia syndrome and orthostatic hypotension.
  60. Thakar A, Deepak K, Kumar S. Auricular syncope. J Laryngol Otol. 2008;122:1115-7 pubmed
    ..To describe a previously unreported syndrome of recurrent syncopal attacks provoked by light stimulation of the external auditory canal...
  61. Romme J, van Dijk N, Boer K, Dekker L, Stam J, Reitsma J, et al. Influence of age and gender on the occurrence and presentation of reflex syncope. Clin Auton Res. 2008;18:127-33 pubmed publisher
    The clinical history is the cornerstone of diagnosing patients with transient loss of consciousness (TLOC). Reflex syncope is the most common cause of TLOC in patients across all ages...