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Nat Rev Cardiol. 2012 Oct;9(10):590-8. doi: 10.1038/nrcardio.2012.102. Epub 2012 Jul 17.
Patients commonly present with syncope at emergency departments and other facilities for urgent care. Syncope is understood by physicians to be a transient, self-terminating period of cerebral hypoperfusion that usually results from systemic hypotension, and clinical guidelines for the care of patients with presumed syncope are available. However, the diagnosis and management of such patients continue to pose important diagnostic, therapeutic, and economic challenges, which are the focus of this Review. First, we discuss how to improve symptom characterization to distinguish syncope from other forms of transient loss of consciousness and syncope mimics. Second, we compare methods of risk stratification in patients with suspected syncope, and recommend the introduction of syncope clinics with enhanced interdisciplinary collaboration to optimize patient care at reduced expense. Third, we highlight the importance of the appropriate selection of diagnostic tools and treatment strategies in these syncope clinics. Finally, we address the difficulties associated with therapy for the most-common form of syncope--vasovagal or reflex syncope.
患者常在急诊室和其他紧急护理机构因晕厥就诊。晕厥通常被医生理解为短暂的、自限性的脑灌注不足期，通常由全身性低血压引起，且存在疑似晕厥患者的护理临床指南。然而，此类患者的诊断和管理仍然存在重要的诊断、治疗和经济挑战，这是本综述的重点。首先，我们讨论如何改善症状特征以区分晕厥与其他形式的短暂意识丧失和晕厥类似物。其次，我们比较疑似晕厥患者的风险分层方法，并建议引入晕厥诊所，加强跨学科合作，以降低成本优化患者护理。第三，我们强调在这些晕厥诊所中适当选择诊断工具和治疗策略的重要性。最后，我们解决与最常见的晕厥形式——血管迷走性或反射性晕厥相关的治疗困难。
