Medtronic
 
 

Insertable
Cardiac Monitor

Syncope and Evaluation

Syncope, a brief self-limited transient loss of consciousness, is a relatively common occurrence in the general population with a variety of underlying causes. It is associated with:

  • 1% to 6% of hospital medical admissions1
  • 3% of emergency room visits each year2
    • 740,000 Emergency Department syncope cases per year in the United States3
    • Overall admissions rate of 32%3
  • $700 million in secondary trauma, including approximately 10% of falls in the elderly4
Common Types of
Syncope
Neurocardiogenic
   — Vasovagel reflex
   — Situational

Cardiac
   — Arrhythmic
   — Structural

Orthostatic

Neurologic

Other
   — Medication
   — Psychogenic

While the underlying cause of syncope can often be determined and appropriate treatment chosen, as many as 47% of all cases of syncope episodes are unexplained.5

Findings from the Framingham Heart Study population suggest additional diagnostic testing and evaluation of unexplained syncope may be advised. A review of over 7,800 patients showed that those with unexplained and cardiac syncope were at increased risk of death.6 In fact, those with:

  • Cardiac syncope had a 6-month mortality rate of greater than 10%6
  • Cardiac syncope had double the risk of death6

Evaluation of Syncope

Diagnosing unexplained syncope can be challenging and frustrating. The following flowchart provides a general protocol to assist in the diagnostic process. An insertable cardiac monitor may help confirm or rule out life-threatening arrhythmias as the cause of recurrent but infrequent fainting.

Syncope Evaluation Flow Chart

References
  1. Kapoor W. Medicine. 1990;69:160-175.
  2. Day SC, et al. Am J Med. 1982;73:15-23.
  3. Sun BC, et al. Acad Emerg Med. 2004;11(10)1029-1034.
  4. Grubb BP, Olshansky B, eds. 2nd. Blackwell Publishing; 2005.
  5. Silverstein MD, et al. JAMA. 1982;248:1185-1189.
  6. Soteriades ES, et al. N Engl J Med. 2000;347:878-885.

Additional Information