Department of Cardiology, Royal Brompton & Harefield Hospitals, England, UK.
Department of Medicine, Royal Lancaster Infirmary, Lancaster, United Kingdom.
Curr Cardiol Rev. 2022;18(6):e210422203887. doi: 10.2174/1573403X18666220421110935.
Syncope is a commonly encountered problem in the emergency department (ED), accounting for approximately 3% of presenting complaints. Clinical assessment of syncope can be challenging due to the diverse range of conditions that can precipitate the symptom. Annual mortality for patients presenting with syncope ranges from 0-12%, and if the syncope is secondary to a cardiac cause, then this figure rises to 18-33%. In ED, it is paramount to accurately identify those presenting with syncope, especially patients with an underlying cardiac aetiology, initiate appropriate management, and refer them for further investigations. In 2018, the European Society of Cardiology (ESC) updated its guidelines with regard to diagnosing and managing patients with syncope. We highlight recent developments and considerations in various components of the workup, such as history, physical examination, investigations, risk stratification, and novel biomarkers, since the establishment of the 2018 ESC guidelines. We further discuss the emerging role of artificial intelligence in diagnosing cardiac syncope and postulate how wearable technology may transform evaluating cardiac syncope in ED.
晕厥是急诊科（ED）中常见的问题，约占就诊主诉的 3%。由于可能引发该症状的病症种类繁多，因此对晕厥进行临床评估具有一定挑战性。晕厥患者的年死亡率为 0-12%，如果晕厥是由心脏原因引起的，那么这一数字上升至 18-33%。在 ED，准确识别晕厥患者至关重要，特别是那些有潜在心脏病因的患者，应启动适当的管理，并将其转介进行进一步检查。2018 年，欧洲心脏病学会（ESC）更新了其关于晕厥患者诊断和管理的指南。我们强调了自 2018 年 ESC 指南建立以来，在病史、体格检查、检查、风险分层和新型生物标志物等各个检查部分的最新进展和考虑因素。我们进一步讨论了人工智能在诊断心源性晕厥中的新兴作用，并推测可穿戴技术如何改变 ED 中心脏性晕厥的评估。
