Prevalence of pulmonary embolism in patients presenting with syncope. A systematic review and meta‐analysis

  title={Prevalence of pulmonary embolism in patients presenting with syncope. A systematic review and meta‐analysis},
  author={Zardasht Oqab and Heather Ganshorn and Robert S. Sheldon},
  journal={American Journal of Emergency Medicine},

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Syncope was a frequent presenting symptom in a study of 224 consecutive patients with PE but was never the sole clinical feature, making it difficult to justify routine testing for PE in patients presenting only with syncope or collapse.
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Although PE should be considered in every patient, not all patients should undergo evaluation for PE, and Pulmonary embolism was rarely identified in patients with syncope.
The diagnostic challenge: are we missing pulmonary embolism diagnosis in patients with syncope?
A retrospective cohort study assessing the incidence of pulmonary embolism 3 month post-discharge after a hospitalization for syncope and the associated 95% confidence interval during hospitalization, incidence of readmission for PE, overall mortality and mortality for PE during the follow-up.
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Prevalence of venous thromboembolism in admissions and readmissions with and without syncope: a nationwide cohort study.
Syncope admissions were associated with a lower prevalence of VTE as compared to non-syncope admissions, and should not trigger an automatic PE workup, rather, be put into context of patient presentation.
Diagnostic yield of pulmonary embolism testing in patients presenting to the emergency department with syncope
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Syncope in haemodynamically stable and unstable patients with acute pulmonary embolism – Results of the German nationwide inpatient sample
Haemodynamically stable PE + Syncope patients were more often treated with systemic thrombolysis and showed a trend to improved survial, while right ventricular dysfunction was a key predictor for syncope.
Introduction of ultrasound at the bedside in the differential diagnosis of the pulmonary embolism as a cause of syncope
This article combines both aspects and provides an interesting point of reflection on the possibility of cushioning the problem of the excess of requests for complementary tests in the emergency departments.


Etiology of syncope in hospitalized patients
Cardiac arrhythmias and neurocardiogenic type are the frequent causes of syncope, with about one-sixth of the patients having no etiology.
Prevalence of Pulmonary Embolism among Patients Hospitalized for Syncope.
Pulmonary embolism was identified in nearly one of every six patients hospitalized for a first episode of syncope, and the prevalence was 17.3% (95% confidence interval, 14.2 to 20.5).
The most common cause of syncope is neurocardiogenic, followed by orthostatic and cardiac, and the diagnostic yield is poor.
Prospective evaluation and outcome of patients admitted for syncope over a 1 year period.
AIMS Syncope is a frequent and potentially dangerous symptom. The epidemiological data are based on series mainly collected 20 years ago in the U.S.A. and do not adequately assist in the management
Diagnostic Value of Neurological Studies in Diagnosing Syncope: A Systematic Review.
Reasons for Hospitalization Among Emergency Department Patients With Syncope.
Cardiac syncope, particularly suspected arrhythmia, was the major reason for ED referrals and hospitalization and development of a risk-stratification tool and out-of-hospital cardiac monitoring strategy should improve patient safety and save substantial resources.
Prospective evaluation of patients with syncope: a population-based study.
Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to a general hospital: the EGSYS score
A simple score derived from clinical history can be usefully employed for the triage and management of patients with syncope in an ED.
Syncope in patients with pulmonary embolism: comparison between patients with syncope as the presenting symptom of pulmonary embolism and patients with pulmonary embolism without syncope
It is suggested that syncope in the setting of non-massive pulmonary embolism may be due to vaso-vagal mechanism that can lead to a reduction of arterial blood pressure when central artery thrombosis is involved.