CardiologyEmergency Medicine
Syncope Assessment
Systematic evaluation of transient loss of consciousness to distinguish vasovagal, cardiac, and orthostatic syncope using ROSE, San Francisco, and Canadian syncope risk scores.
Source: ESC 2018 Syncope Guidelines; NICE NG109
Step 1 of ~7
action
History and Witnesses
Syncope = transient loss of consciousness (T-LOC) due to global cerebral hypoperfusion.
Key history:
• Circumstances: posture (lying/standing/exertion), triggers (pain, emotion, prolonged standing, micturition)
• Prodrome: nausea, sweating, visual dimming (vasovagal) vs. palpitations, chest pain (cardiac)
• Recovery: rapid (vasovagal — seconds) vs. prolonged (post-ictal from seizure — minutes)
• Witnesses: tonic-clonic movements, eye deviation (seizure), tongue biting, incontinence
• Past history: heart disease, medications (antihypertensives, QT-prolonging), family history (sudden death)
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Lidocaine IV (Cardiac Arrhythmia) · Antiarrhythmic
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Mavacamten · Cardiac myosin inhibitor
- Prednisolone (Sudden Sensorineural Hearing Loss) · Corticosteroid (systemic — SSNHL treatment)
- Digoxin · Cardiac Glycoside
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
Pathways
- 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
Decision support only. Always apply local guidelines and clinical judgement.