Monday, July 26, 2010

Cost effective evaluation of syncope

From The Hospitalist. Some key points:

Among diagnostic tests, orthostatic blood pressure measurement (performed in about one-third of cases) is both the highest-yield test and the least expensive….

Cardiac enzymes, electroencephalography, CT scan of the head, and carotid ultrasonography contribute to diagnosis in less than 1% of cases. Echo is helpful about 2% of cases. Even inpatient telemetry, a routine part of standard evaluation, is helpful only 5% of the time.

Patients can be reassured that, in the absence of underlying cardiac disease, syncope itself is not associated with increased mortality.

The San Francisco Syncope Rule was mentioned.

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