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Cited by 539Cardiovascular Syncope and Autonomic DisordersCardiac electrophysiology and arrhythmiasTakotsubo Cardiomyopathy and Associated Phenomena

Evaluation and Outcome of Patients with Syncope

KAPOOR, WISHWA N.·1990·Medicine
DOI 10.1097/00005792-199005000-00004
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Abstract

We studied 433 patients with syncope to derive insights into the diagnostic evaluation and outcome of patients with this common problem. This study shows that the etiology of syncope was not found in approximately 41% of patients. When a cause of syncope was determined, it was most frequently established on the basis of initial history, physical examination and an electrocardiogram (EKG). Furthermore, many of the other entities (e.g., aortic stenosis, subclavian steal) were suggested by findings on the history and physical examinations that required directed diagnostic testing. Initial EKG was abnormal in 50% of patients but led to a cause of syncope infrequently (less than 7%). Prolonged electrocardiographic monitoring, which has assumed a central role in the evaluation of syncope, led to a specific cause in only 22% of patients. Other tests were less often helpful in assigning a cause of syncope. At 5 years, the mortality of 50.5% in patients with a cardiac cause of syncope was significantly higher than the 30% mortality in patients with a noncardiac cause or 24.1% in patients with an unknown cause. At 5 years, a mortality of 50.5% in patients with a cardiac cause of syncope was noted. There were 54 actual deaths in this group as compared to 10.7 expected deaths based on 1980-86 mortality data from Allegheny County, PA (standardized mortality ratio = 5.02). At 5 years, a 33.1% incidence of sudden death was noted in patients with cardiac cause of syncope, as compared with 4.…

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  • The presence of significant cardiovascular diseases, often associated with the cardiovascular causes of syncope, portends a poor prognosis.

    “The presence of significant cardiovascular diseases, often associated with the cardiovascular causes of syncope, portends a poor prognosis (35,132).”

    From 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (2017) · cites this paper as [132]

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Authors
KAPOOR, W. N.
Affiliations
University of Pittsburgh (US)
Corresponding author
KAPOOR, WISHWA N.
Venue
Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1990-05
Volume
69
Issue
3
Pages
160-175
ISSN
0025-7974 (ISSN-L)
DOI
10.1097/00005792-199005000-00004
OpenAlex
W2080419997
Cited by
539
References
0
Citations by year
2026: 2 · 2025: 5 · 2024: 6 · 2023: 6 · 2022: 5 · 2021: 9 · 2020: 13 · 2019: 12 · 2018: 14 · 2017: 16 · 2016: 13 · 2015: 7 · 2014: 26 · 2013: 32 · 2012: 26
FWCI
10.24
Type
journal article
Language
en
Open access
closed
Locations
  • Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01hl036735-02)
  • U.S. Public Health Service (K04L 01899)
  • National Heart, Lung, and Blood Institute (R01-HL36735)
Topics
  • Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Takotsubo Cardiomyopathy and Associated Phenomena
Keywords
syncope, syncope etiology, cardiac syncope, sudden death, mortality, electrocardiogram, aortic stenosis, subclavian steal syndrome, syncope recurrence, vascular events, diagnostic assessment, long-term outcomes
MeSH terms
Adult, Cough, Defecation, Electrocardiography, Electrophysiology, Female, Follow-Up Studies, Heart Diseases, Humans, Male, Middle Aged, Mortality, Prognosis, Recurrence, Syncope, Urination, Electrocardiography, Ambulatory

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