PURPOSE: To evaluate the workup of patients admitted to the hospital with syncope and to evaluate that clinical practice guidelines for syncope were followed.
METHODS: We retrospectively reviewed medical records of 104 patients (50 males, 54 females, age range 23-93; mean age 63.8 yrs) with the principal diagnosis of syncope over a period of 6 months and examined their initial diagnostic workup including CT-head and carotid Doppler ultrasound.
RESULTS: Only one patient had focal neurological deficit on initial presentation. Both his carotid ultrasound and CT-head were abnormal. 55 (52.8%) patients had carotid doppler ultrasound and 62 (59.6%) patients had CT-head despite normal physical examination; both tests were normal.
CONCLUSION: These data suggest that the use of imaging studies in the evaluation of syncope has a low diagnostic yield. Careful history, and physical examination should help guide diagnostic testing.
CLINICAL IMPLICATIONS: The use of published clinical guidelines for syncope is a good tool for the diagnostic workup. Patients with no focal neurologic deficit on physical examination are unlikely to benefit from radiological imaging.
DISCLOSURE: M. Ismail, None.
M. Shubair MD N. Jallad MD H. Aziz MD M. Ismail MD * M.A. Khan MD St. Joseph's Regional Medical Center, Paterson, NJ
COPYRIGHT 2005 American College of Chest Physicians
COPYRIGHT 2005 Gale Group
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