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Is There an Effective Treatment for Neurally Mediated Syncope?
Wishwa N. Kapoor, MD, MPH
JAMA. 2003;289:2272-2275.
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During the past 20 years, a great deal has been learned about the evaluation, management, and prognosis of syncope. Studies from the 1980s showed that for approximately half of patients with syncope, the cause could not be established using diagnostic tests widely available at the time.1 Studies of risk stratification showed that the most important predictor of a poor outcome was underlying structural heart disease, including abnormalities detected on electrocardiogram.2-3 These findings prompted investigators to devise new diagnostic tests and to propose alternative strategies for managing syncope.
In the subset of patients with syncope and structural heart disease, the focus shifted to extensive evaluation of cardiovascular disease and to the use of electrophysiological studies to test for arrhythmias. In the subset of patients who have syncope, but in whom structural heart disease or other cardiac etiology could not be diagnosed and did not seem clinically . . . [Full Text of this Article]
Author Affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, Pa.
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