Syncope : comment organiser le bilan initial ? Quels patients doit-on hospitaliser ?

摘要

Initial evaluation of patients with syncope is based on history taking, physical examination (including supine and standing blood pressure measurements), and baseline 12-lead electrocardiogram. The initial management should answer the following three questions: (1) Is the diagnosis of syncope confirmed?, (2) Is there a clear aetiological diagnosis?, (3) Is there a high risk of cardiovascular events or death? Risk stratification aims to distinguish ? low risk ? patients, who con be discharged, from ? high risk ? patients, who require admission. Risk stratification is mainly based on the identification of an underlying cardiac disease and electrocardiogram analysis. The main objective of risk stratification is to identify patient with cardiac syncope, who maybe at risk of sudden death.