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Cited by 120Cardiovascular Syncope and Autonomic DisordersCardiovascular and Diving-Related ComplicationsTakotsubo Cardiomyopathy and Associated Phenomena

Role of echocardiography in the evaluation of syncope: a prospective study

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Sarasin, F P, Junod, A-F, Carballo, D, Slama, S, Unger, P-F, Louis-Simonet, M·2002·Heart
DOI 10.1136/heart.88.4.363PMC PMC1767372
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Abstract

OBJECTIVE: To study the role of echocardiography in the stepwise evaluation of syncope. DESIGN: A prospective observational study with an 18 month follow up. SETTING: University teaching hospital providing primary and tertiary care. SUBJECTS: 650 consecutive patients with syncope and clinical suspicion of an obstructive valvar lesion, or with syncope not explained by history, physical examination, or a 12 lead ECG, who underwent bidimensional Doppler transthoracic echocardiography. MAIN OUTCOME MEASURES: The causes of syncope were assigned using published diagnostic criteria. Echocardiography was considered diagnostic when confirming a suspected diagnosis, or when revealing occult cardiac disease explaining the syncope. RESULTS: A systolic murmur was identified in 61 of the 650 patients (9%). Severe aortic stenosis was suspected in 20 of these and was confirmed by echocardiography in eight. Follow up excluded further cases of aortic stenosis. In patients with unexplained syncope (n = 155), routine echocardiography showed no abnormalities that established the cause of the syncope. Echocardiography was normal or non-relevant in all patients with a negative cardiac history and a normal ECG (n = 67). In patients with a positive cardiac history or an abnormal ECG (n = 88), echocardiography showed systolic dysfunction (left ventricular ejection fraction < or = 40%) in 24 (27%) and minor non-relevant findings in the remaining 64. Arrhythmias were diagnosed in 12 of the 24 patients with systolic dysfunction (50%), and in 12 of the 64 remaining patients (19%) (p < 0.01). CONCLUSIONS: Echocardiography was most useful for assessing the severity of the underlying cardiac disease and for risk stratification in patients with unexplained syncope but with a positive cardiac history or an abnormal ECG.

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  • For patients with suspected heart disease, echocardiography serves to confirm or refute the suspicions in equal proportions.

    “For patients with suspected heart disease, echocardiography serves to confirm or refute the suspicions in equal proportions”

    From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [236]

    The Results report that echocardiography confirmed severe aortic stenosis in 8 of 20 patients in whom it was suspected—40%, not an equal proportion. The study concerns selected patients with syncope and suspected aortic stenosis, rather than patients with suspected heart disease generally. (LLM, conf=0.85)

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  • For patients with suspected heart disease, echocardiography plays an important role in risk stratification.

    “and plays an important role in risk stratification. 235,236”

    From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [236]

    The Discussion says echocardiography provided useful information for risk stratification in patients with unexplained syncope and a positive cardiac history or abnormal ECG. The Conclusions repeat that restriction; the claim broadens the finding to patients with suspected heart disease generally. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 2

  1. Kapoor WN. Syncope. N Engl J Med 2000;343:1856-62.
  2. Tunstall-Pedoe H, Kuulasmaa K, Amouyel P, et al. Myocardial infarction and coronary deaths in the World Health Organization Monica Project. Circulation 1994;90:583-612.

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Authors
Sarasin, F. P., Junod, A.-F., Carballo, D., Slama, S., Unger, P.-F., & Louis-Simonet, M.
Affiliations
University of Geneva (CH)
Corresponding author
Sarasin, F P
ORCID
Sarasin, F P
Venue
Heart
Publisher
BMJ
Published
2002-10
Volume
88
Issue
4
Pages
363-367
ISSN
  • 1355-6037 (ISSN-L)
  • 1468-201X
DOI
10.1136/heart.88.4.363
PMC
PMC1767372
OpenAlex
W2114819248
Cited by
120
References
30
Citations by year
2026: 2 · 2025: 4 · 2024: 3 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 1 · 2019: 10 · 2018: 14 · 2017: 11 · 2016: 7 · 2015: 5 · 2014: 9 · 2013: 6 · 2012: 3
FWCI
2.22
Type
journal article
Language
en
Open access
Locations
  • Heart (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Research Foundation
  • Université de Genève
Topics
  • Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Takotsubo Cardiomyopathy and Associated Phenomena
Keywords
syncope, echocardiography, aortic stenosis, systolic murmur, systolic dysfunction, left ventricular ejection fraction, cardiac arrhythmias, risk stratification, unexplained syncope
MeSH terms
Aged, Echocardiography, Female, Follow-Up Studies, Heart Diseases, Humans, Male, Prospective Studies, Syncope

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