Syncope

Preview

Syncope is an urgent and frustrating problem, and comprehensive testing for it is expensive and reveals a cause in only approximately half of the cases. Dr Radack suggests a focused evaluation based on a meticulous history, physical examination, and 12-lead ECG, which can be followed by additional procedures such as ambulatory ECG monitoring or electrophysiologic studies if indicated to pursue a specific suspected cause. He also summarizes the controversies over syncope and the reasons why published reports cannot be applied to primary care practice. A flowchart of suggested diagnostic steps is provided, with typical prices of the various testing procedures included as an aid to cost analysis.