EGSYS Score for Syncope
Differentiates cardiac from non-cardiac syncope. Score ≥3 suggests cardiac aetiology.
Score interpretation
Score <3: Cardiac aetiology unlikely. Vasovagal or reflex syncope probable.
→ Consider tilt-table testing if recurrent. Outpatient follow-up appropriate.
Score ≥3: Cardiac cause of syncope likely (sensitivity 95%, specificity 61%).
→ Urgent cardiac evaluation. Admit for monitoring and echocardiogram.
Interpretation bands for the EGSYS. Apply clinical judgement and local guidance.
References
- Del Rosso A et al. Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to a general hospital. Eur Heart J. 2008;29(13):1649-1654.
Related
Curated clinical cross-links plus same-class fallbacks.
- Lidocaine IV (Cardiac Arrhythmia) · Antiarrhythmic
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Mavacamten · Cardiac myosin inhibitor
- Digoxin · Cardiac Glycoside
- Arsenic Trioxide · Differentiation Agent / Cytotoxic (Specialist Oncology Drug)
- Aprotinin · Antifibrinolytic — Cardiac Surgery
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
The EGSYS is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.