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Diagnostic value of history in patients with syncope with or without heart disease

Paolo Alboni, MD, FACC^*, Michele Brignole, MD, Carlo Menozzi, MD, Antonio Raviele, MD, Attilio Del Rosso, MD^||, Maurizio Dinelli, MD^*, Alberto Solano, MD and Nicola Bottoni, MD

^* Division of Cardiology, Ospedale Civile, Cento, Italy
Section of Arrhythmology, Department of Cardiology, Ospedali Riuniti, Lavagna, Italy
Section of Arrhythmology, Department of Cardiology, Ospedale S. Maria Nuova, Reggio Emilia, Italy
Division of Cardiology, Ospedale Umberto I, Mestre, Italy
^|| Division of Cardiology, Ospedale S. Pietro Igneo, Fucecchio, Italy

View larger version (31K): [in a new window]   Figure 1 Algorithm for diagnostic approach to syncope proposed by the Italian "Associazione Nazionale Medici Cardiologi Ospedalieri" (1,2), modified with the introduction of the adenosine triphosphate (ATP) test. Circled minus sign = not a diagnostic examination; ? = indication to be evaluated case by case; CAT = computed axial tomography; CSM = carotid sinus massage; ECHO = echocardiogram; EEG = electroencephalogram; ES = electrophysiologic study; ET = exercise test.

View larger version (12K): [in a new window]   Figure 2 Causes of syncope in patients (pts) with and without suspected or certain heart disease after the initial evaluation.