Do Orthostatic Vital Signs Have Utility in the Evaluation of Syncope?

Jason Schaffer, Samuel M. Keim, Benton Hunter, Jonathan Kirschner, Robert A. De Lorenzo

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalJournal of Emergency Medicine
DOIs
StateAccepted/In press - Jan 1 2018

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Keywords

  • dehydration
  • diagnostic tests
  • orthostatic vital signs
  • syncope

ASJC Scopus subject areas

  • Emergency Medicine

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