Clasen Lukas, Makimoto Hisaki, von Scheidt Wolfgang
Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf.
I. Medizinischen Klinik, Universitätsklinikum Augsburg, Herzzentrum Augsburg-Schwaben, Augsburg.
Dtsch Med Wochenschr. 2019 Aug;144(15):1040-1043. doi: 10.1055/a-0663-1390. Epub 2019 Jul 26.
Syncope is one of the most frequent mode of hospital visits in the emergency department. A broad range of causalities and healthcare economic efficiency have demanded reasonable road maps for diagnostic procedures and hospital admission of patients with syncope. Recent advances and multidisciplinary assessments provided the basis of the updated 2018 ESC Guidelines for the diagnosis and management of syncope. While the definitions of syncope remain unchanged these updates state risk stratification in the emergency department with clear diagnostic paths and monitoring in the current era with portable devices. The algorithm for reflex syncope therapy, indication for cardiac pacemakers and implantable cardioverter-defibrillators in high-risk patients for sudden cardiac death were modified. Finally, the updated guidelines recommend an establishment of "syncope-unit" with multidisciplinary involvement.
晕厥是急诊科最常见的就诊原因之一。多种病因及医疗经济效率要求为晕厥患者的诊断程序和住院制定合理的路线图。近期的进展和多学科评估为2018年欧洲心脏病学会（ESC）晕厥诊断和管理指南的更新提供了基础。虽然晕厥的定义保持不变，但这些更新阐述了急诊科的风险分层，明确了诊断路径以及当前时代使用便携式设备进行监测的情况。反射性晕厥治疗算法、心脏起搏器的适应证以及高危心源性猝死患者植入式心脏复律除颤器的适应证均有所修改。最后,更新后的指南建议建立多学科参与的“晕厥单元”。
