Vacek J L
Mid-America Cardiology Associates, Kansas City, MO 64111.
Postgrad Med. 1991 Oct;90(5):175-8, 181-4. doi: 10.1080/00325481.1991.11701082.
Evaluation of syncope may be lengthy and expensive, and, in up to 50% of patients, will not produce a diagnosis. If a definite cause is found, specific therapy may offer symptomatic relief, although the patient's prognosis depends primarily on the nature and severity of any underlying disease. A patient with no evidence of organic heart disease for whom a complete evaluation reveals no cause for syncope has an excellent prognosis, even though syncopal symptoms may recur. The initial evaluation and management of most patients with syncope can be performed by the primary care physician if facilities for Holter monitoring, echocardiography, and signal-averaged electrocardiography are available. Consultation with a cardiologist is necessary only when the results of the initial evaluation are unrevealing or if findings suggest the need for a more intensive secondary elevation.
晕厥的评估可能耗时且费用高昂，而且在多达50%的患者中无法得出诊断结果。如果找到明确病因，特定治疗可能会缓解症状，不过患者的预后主要取决于任何潜在疾病的性质和严重程度。没有器质性心脏病证据且全面评估未发现晕厥病因的患者预后良好，即便晕厥症状可能复发。如果有动态心电图监测、超声心动图和信号平均心电图检查设备，大多数晕厥患者的初步评估和处理可由初级保健医生进行。只有当初始评估结果无异常发现，或者检查结果表明需要更深入的二级评估时，才需要咨询心脏病专家。
