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Syncope : new solutions for an old problem

Rivasi, Giulia ; Ungar, Andrea ; Moya, Angel ; Brignole, Michele ; Sutton, Richard and Fedorowski, Artur LU orcid (2021) In Kardiologia Polska 79(10). p.1068-1078
Abstract

Syncope is a frequent event in the general population. Approximately 1%-2% of all emergency department admissions are due to syncope and at least one third of all people experience fainting in their life. Although consequences of cardiac syncope are generally feared, non-cardiac syncope is much more common and may be associated with severe injuries and quality of life impairment, particularly in older adults. Various diagnostic and therapeutic strategies have been created and implemented over decades, leading to significant improvements in diagnostic accuracy and treatment effectiveness. In recent years, diagnosis and treatment have further evolved according to an innovative approach focused on the hemodynamic mechanism underlying... (More)

Syncope is a frequent event in the general population. Approximately 1%-2% of all emergency department admissions are due to syncope and at least one third of all people experience fainting in their life. Although consequences of cardiac syncope are generally feared, non-cardiac syncope is much more common and may be associated with severe injuries and quality of life impairment, particularly in older adults. Various diagnostic and therapeutic strategies have been created and implemented over decades, leading to significant improvements in diagnostic accuracy and treatment effectiveness. In recent years, diagnosis and treatment have further evolved according to an innovative approach focused on the hemodynamic mechanism underlying syncope, based upon the assumption that knowledge of syncope mechanism is a prerequisite for effective syncope prevention and treatment. Therefore, a new classification of syncope has been proposed, which defines two main syncope phenotypes with different predominant mechanisms: the hypotensive phenotype, where hypotension or vasodepression prevails, and the bradycardic phenotype, where cardioinhibition prevails. Identification of syncope phenotype - bradycardic or hypotensive/vasodepressive - represents the first step towards a personalized management of syncope, characterized by customized interventions for prevention. The present review is aimed at illustrating these new developments in diagnosis and therapy of non-cardiac syncope within a mechanism-based perspective. Diagnosis and therapy of bradycardic and hypotensive phenotypes are discussed, with a focus on recent evidence.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Kardiologia Polska
volume
79
issue
10
pages
1068 - 1078
publisher
Polskie Towarzystwo Kardiologiczne
external identifiers
  • scopus:85119280261
  • pmid:34668180
ISSN
1897-4279
DOI
10.33963/KP.a2021.0138
language
English
LU publication?
yes
id
261cee78-62a5-4ca1-a60c-122c0850a75f
date added to LUP
2021-10-22 10:40:27
date last changed
2024-03-23 12:03:21
@article{261cee78-62a5-4ca1-a60c-122c0850a75f,
  abstract     = {{<p>Syncope is a frequent event in the general population. Approximately 1%-2% of all emergency department admissions are due to syncope and at least one third of all people experience fainting in their life. Although consequences of cardiac syncope are generally feared, non-cardiac syncope is much more common and may be associated with severe injuries and quality of life impairment, particularly in older adults. Various diagnostic and therapeutic strategies have been created and implemented over decades, leading to significant improvements in diagnostic accuracy and treatment effectiveness. In recent years, diagnosis and treatment have further evolved according to an innovative approach focused on the hemodynamic mechanism underlying syncope, based upon the assumption that knowledge of syncope mechanism is a prerequisite for effective syncope prevention and treatment. Therefore, a new classification of syncope has been proposed, which defines two main syncope phenotypes with different predominant mechanisms: the hypotensive phenotype, where hypotension or vasodepression prevails, and the bradycardic phenotype, where cardioinhibition prevails. Identification of syncope phenotype - bradycardic or hypotensive/vasodepressive - represents the first step towards a personalized management of syncope, characterized by customized interventions for prevention. The present review is aimed at illustrating these new developments in diagnosis and therapy of non-cardiac syncope within a mechanism-based perspective. Diagnosis and therapy of bradycardic and hypotensive phenotypes are discussed, with a focus on recent evidence.</p>}},
  author       = {{Rivasi, Giulia and Ungar, Andrea and Moya, Angel and Brignole, Michele and Sutton, Richard and Fedorowski, Artur}},
  issn         = {{1897-4279}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1068--1078}},
  publisher    = {{Polskie Towarzystwo Kardiologiczne}},
  series       = {{Kardiologia Polska}},
  title        = {{Syncope : new solutions for an old problem}},
  url          = {{http://dx.doi.org/10.33963/KP.a2021.0138}},
  doi          = {{10.33963/KP.a2021.0138}},
  volume       = {{79}},
  year         = {{2021}},
}