Vascular Causes of Syncope: An Emergency Medicine Review

Brit Long, Alex Koyfman

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Syncope is a common emergency department (ED) complaint, accounting for 2% of visits annually. A wide variety of etiologies can result in syncope, and vascular causes may be deadly. Objective: This review evaluates vascular causes of syncope and their evaluation and management in the ED. Discussion: Syncope is defined by a brief loss of consciousness with loss of postural tone and complete, spontaneous recovery without medical intervention. Causes include cardiac, vasovagal, orthostatic, neurologic, medication-related, and idiopathic, and most cases of syncope will not receive a specific diagnosis pertaining to the cause. Emergency physicians are most concerned with life-threatening causes such as dysrhythmia and obstruction, and electrocardiogram is a primary means of evaluation. However, vascular etiologies can result in patient morbidity and mortality. These conditions include pulmonary embolism, subclavian steal, aortic dissection, cerebrovascular disease, intracerebral hemorrhage, carotid/vertebral dissection, and abdominal aortic aneurysm. A focused history and physical examination can assist emergency physicians in determining the need for further testing and management. Conclusions: Syncope is common and may be the result of a deadly condition. The emergency physician, through history and physical examination, can determine the need for further evaluation and resuscitation of these patients, with consideration of vascular etiologies of syncope.

Original languageEnglish (US)
JournalJournal of Emergency Medicine
DOIs
StateAccepted/In press - 2017

Fingerprint

Emergency Medicine
Syncope
Blood Vessels
Emergencies
Physicians
Physical Examination
Dissection
Hospital Emergency Service
Subclavian Steal Syndrome
Cerebrovascular Disorders
Unconsciousness
Abdominal Aortic Aneurysm
Cerebral Hemorrhage
Pulmonary Embolism
Resuscitation
Nervous System
Electrocardiography
History
Morbidity
Mortality

Keywords

  • Abdominal aortic aneurysm
  • Aortic dissection
  • Carotid dissection
  • Cerebrovascular disease
  • Intracerebral hemorrhage
  • Pulmonary embolism
  • Subarachnoid hemorrhage
  • Subclavian steal
  • Syncope
  • Vascular
  • Vertebral dissection

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Vascular Causes of Syncope : An Emergency Medicine Review. / Long, Brit; Koyfman, Alex.

In: Journal of Emergency Medicine, 2017.

Research output: Contribution to journalArticle

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