TY - JOUR
T1 - Do Orthostatic Vital Signs Have Utility in the Evaluation of Syncope?
AU - Schaffer, Jason T.
AU - Keim, Samuel M
AU - Hunter, Benton R.
AU - Kirschner, Jonathan M.
AU - De Lorenzo, Robert A.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: Syncope is a common presentation in the emergency department (ED). The differential diagnosis is long and includes benign conditions as well as acute life threats, such as dysrhythmias or pulmonary embolism. Objective: The specific goals of this review are twofold: 1) to define the diagnostic utility of orthostatic vital signs (OVS) as a test for orthostatic syncope, and 2) to determine whether OVS help diagnose or exclude life-threatening causes of syncope in ED patients. Methods: Three prospective cohort studies plus 2017 national guidelines for syncope management were identified, reviewed, and critically appraised. Results: This literature review found that orthostatic hypotension is common among ED patients with syncope and is often diagnosed as the cause of syncope. Conclusions: OVS measurements do not, in isolation, reliably diagnose or exclude orthostatic syncope, nor do they appear to have value in ruling out life-threatening causes of syncope.
AB - Background: Syncope is a common presentation in the emergency department (ED). The differential diagnosis is long and includes benign conditions as well as acute life threats, such as dysrhythmias or pulmonary embolism. Objective: The specific goals of this review are twofold: 1) to define the diagnostic utility of orthostatic vital signs (OVS) as a test for orthostatic syncope, and 2) to determine whether OVS help diagnose or exclude life-threatening causes of syncope in ED patients. Methods: Three prospective cohort studies plus 2017 national guidelines for syncope management were identified, reviewed, and critically appraised. Results: This literature review found that orthostatic hypotension is common among ED patients with syncope and is often diagnosed as the cause of syncope. Conclusions: OVS measurements do not, in isolation, reliably diagnose or exclude orthostatic syncope, nor do they appear to have value in ruling out life-threatening causes of syncope.
KW - dehydration
KW - diagnostic tests
KW - orthostatic vital signs
KW - syncope
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U2 - 10.1016/j.jemermed.2018.09.011
DO - 10.1016/j.jemermed.2018.09.011
M3 - Article
C2 - 30316621
AN - SCOPUS:85054432023
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
SN - 0736-4679
ER -