Syncope

Decision

Was it true syncope?

(ie. none of the conditions in background section are suspected)

Yes

Perform history, physical examination, ECG (Class I)

Is There A Life-Threatening Cause?

Evaluate as appropriate for seizure, psychogenic, or rare causes of TLOC

Background

Syncope Mimics

Neurologic Causes Without Generalized Cerebral Hypoperfusion

Generalized seizures
Complex partial seizures
Intracerebral hemorrhage
Subarachnoid hemorrhage
Vertebrobasilar transient ischemic attack
Complicated migraine

Psychiatric Causes

Psychogenic pseudosyncope
Anxiety disorder
Cataplexy
Somatization disorder

Metabolic Disorders

Hypoglycemia
Hypoxia
Hypercapnia
Hypocapnia (hyperventilation)
Intoxication

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Emergency Department Management of Syncope | EB Medicine

Identifying the cause of syncope can be difficult, but a structured ED approach can help separate life-threatening causes from benign ones, reducing hospitalizations and improving care

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Emergency Department Management of Syncope | EB Medicine

Full Syncope Pathway

Is There A Life-Threatening Cause?