• Ramy Abdelfattah
  • Hanna Z. MieszczanskaEmail author


Syncope is a common problem encountered in cardiology consults that can be due to various causes, ranging from benign to life-threatening conditions. The role of the consultant is to risk stratify the patient in order to guide the treatment and prevent long-term morbidity and mortality. This is primarily achieved by identifying or excluding an underlying cardiac etiology. Identifying the cause of syncope allows for proper management which significantly improves the quality of the patient’s life and prevents injury to the patient or others.


Syncope Near-syncope Vasovagal syncope Orthostatic hypotension Arrhythmias 


  1. 1.
    Runser LA, Gauer RL, Houser A. Syncope: evaluation and differential diagnosis. 2017;95(5):303–12.
  2. 2.
    Chen LY, Shen WK, Mahoney DW, Jacobsen SJ, Rodeheffer RJ. Prevalence of syncope in a population aged more than 45 years. Am J Med. 2006;119(12):1–7.Google Scholar
  3. 3.
    Soteriades ES, Evans JC, Larson MG, Chen MH, Chen L, Benjamin EJ, et al. Incidence and prognosis of syncope. N Engl J Med [Internet]. 2002;347(12):878–85. Scholar
  4. 4.
    Linzer M, Yang EH, Estes NM, Wang P, Vorperian VR, Kapoor WN. CLINICAL GUIDELINE: diagnosing syncope: part 1: value of history, physical examination, and electrocardiography. Ann Intern Med. 1997;126:989–96.
  5. 5.
    Linzer M, Yang EH. Diagnosing syncope. Ann Intern Med [Internet]. 1997;127(1):76. Scholar
  6. 6.
    Kapoor WN. Current evaluation and management of syncope. Circulation. 2002;106(13):1606–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Shen W, Sheldon RS, Benditt DG, Link MS, Cohen MI, Olshansky B, et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society [Internet]. Heart Rhythm. 2017;155–217.
  8. 8.
    Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011;21(2):69–72.CrossRefPubMedGoogle Scholar
  9. 9.
    Oh JH, Hanusa BH, Kapoor WN. Do symptoms predict cardiac arrhythmias and mortality in patients with syncope? Arch Intern Med [Internet]. 1999;159(4):375–80. Scholar
  10. 10.
    Ruwald MH, Ruwald AC, Jons C, Lamberts M, Hansen ML, Vinther M, et al. Evaluation of the chads2 risk score on short- and long-term all-cause and cardiovascular mortality after syncope. Clin Cardiol. 2013;36(5):262–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Arthur W, Kaye GC. The pathophysiology of common causes of syncope. Postgrad Med J [Internet]. 2000;76(902):750–3. Scholar
  12. 12.
    Strickberger SA, Benson W, Biaggioni I, Callans DJ, Cohen MI, Ellenbogen KA, et al. AHA/ACCF scientific statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2006;113(2):316–27.CrossRefPubMedGoogle Scholar
  13. 13.
    Shen W-K, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD, et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope. J Am Coll Cardiol [Internet]. 2017;70(5):e39–110. Scholar
  14. 14.
    Shen W-K, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD, et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope. Heart Rhythm [Internet]. 2017;14(8):e155–217. Elsevier Inc. Scholar
  15. 15.
    Low PA, Sandroni P, Joyner M, Shen W-K. Clinical review postural tachycardia syndrome (POTS). J Cardiovasc Electrophysiol. 2009;20:352–8.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Sanford Bemidji Medical CenterBemidjiUSA
  2. 2.University of Rochester Medical Center/CardiologyRochesterUSA

Personalised recommendations