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The value and limitation of noninvasive ECG examination in the diagnosis of syncope |
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Abstract Syncope is a commonly encountered symptom, and its diagnosis and treatment involve multiple clinical subjects. It seriously affects the life quality of patients, however, its etiology is unknown among about 1/3 of these patients. Therefore, the diagnosis and evaluation of syncope are very important. Vasovagal syncope is common in neurallymediated syncope with good prognosis; cardiac syncope is often induced by arrhythmia with poor prognosis and high mortality. Both of the 2017 ACC/AHA/HRS and 2018 ESC guidelines for the diagnosis and management of syncope have analyzed the risk factors for syncope, and formulated clinical evaluation procedures correspondingly. “Chinese expert consensus statement on clinical diagnosis and treatment of syncope 2018” fully affirmed the criteria and procedures of diagnosis and evaluation for syncope in the above guidelines, emphasized on short and longterm risk stratification, and standardized initial assessment, in order to raise diagnosis rate and reduce medical cost. Based on characteristics of various noninvasive ECG examinations, and their application and limitations in the diagnosis and evaluation of syncope, this article suggests that ECG examination should be reasonably selected according to the frequency, severity and feature of syncope so as to prevent sudden death caused by cardiac syncope.
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