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Review 10: Did This Patient Have Cardiac Syncope? The Rational Clinical Examination Systematic Review

Reviewer

Denise Marte, MD

Department of Emergency Medicine, Weill Cornell School of Medicine, New York, NY

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1. Article Citation
2. Synopsis
3. ABEM Quick Quiz
4. Discussion
5. Critique
6. ABEM Quick Quiz Answers
7. Key Points
8. Table
   1. Table 1. Characteristics of Cardiac Syncope, Reflex Syncope, and Orthostatic Hypotension
   2. Table 2. Factors Associated With a Greater Likelihood of Cardiac Syncope
   3. Table 3. Factors Associated With a Lower Likelihood of Cardiac Syncope
9. Original Article

Article Citation

Albassam OT, Redelmeier RJ, Shadowitz S, et al. Did this patient have cardiac syncope? The rational clinical examination systematic review. JAMA. 2019;321(24):2448-2457.

Synopsis

This systematic review of 11 studies sought to assess the accuracy and efficacy of the clinical examination in determining which adult patients have cardiac syncope versus syncope from other causes. Multiple historical, physical, and diagnostic factors were assessed, and the authors concluded that the clinical examination with electrocardiography (ECG) utilized in clinical assessment scores can identify and differentiate cardiac syncope.

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