Syncope is a common clinical entity that disturbs patients, physicians and health care providers. More than 40% of individuals experience a syncopal episode in their life span while syncope is responsible for approximately 1% of emergency department visits per year. Furthermore, syncope has a huge impact on patients’ quality of life while the cost of evaluating and treating such patients is high. In this interesting session, Prof. R. Sutton underlined the significant role of clinical evaluation, including medical history and physical examination, which, combined with ECG, yields a diagnosis of about 40%, adds to patient risk stratification and finally to the treatment. In the same session Prof. A. Moya analyzed the reasons for setting up a syncope unit and presented data showing that such units may reduce the cost of the diagnostic process, increase the diagnostic yield and allow specific treatment. Prof. M. Brignole pointed out the high diagnostic power of the implantable loop recorders, their indications and showed that currently these devices are largely underused. Finally, Prof. R.A. Kenny referred to the pitfalls in diagnosis and management of syncope. She mentioned that the accuracy of medical history is less likely with advancing age due to the rising prevalence of cognitive impairment and dementia. She also concluded that syncope in young age is not necessarily benign while unexplained falls, drop attacks and resistant epilepsy could be in a high percentage be of cardiovascular origin.
In conclusion we can say that although we have learnt a lot about the management of syncopal patients, challenges still remain.
Management of syncope patients. Still a challenge
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