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The risk stratification of syncope: interpretation of 2018 ESC and 2017 ACC/AHA/HRS guidelines for the diagnosis and management of syncope |
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Abstract Syncope is a common symptom. Neurocardiogenic syncope has a good prognosis; syncope induced by orthostatic hypotension is at a low risk of sudden death; cardiogenic syncope has a poor prognosis and sometimes is probably a sign of sudden death. The causes of about 1/3 of syncope are unknown after initial evaluation. Therefore, it is very important to make risk stratification of syncope which determines the management strategy clinically. According to 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope, those with syncope are classified as being at short or longterm risk. Different from previous versions, factors such as male, age, tumor, cerebrovascular diseases, diabetes, high CHADS2 scores and renal function are also included in the risk stratification this time. In 2018 ESC guidelines for the diagnosis and management of syncope, patients with syncope are labelled as high risk and low risk ones according to medical history, physical symptom and supplementary examination result. High risk patients are suggested actively accepting examination and treatment while low risk patients are mainly given proper patient education, advices for changing lifestyles and physiotherapy.
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HE Wen-Yi, DENG Guo-Lan. [J]. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2019, 28(5): 378-380. |
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