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Prognosis of Syncope Across the Diagnostic Spectrum

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Syncope

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Abstract

Syncope has outcomes ranging from the benign to the ultimately sinister depending on the underlying cause. In this chapter, I will focus initially on the determinants of syncope prognosis before turning to the likelihood of symptom recurrence and mortality over different time frames (short and long term) following the initial presentation. I will review the tools of the trade that can inform prognostication alongside the clinical features that help the clinician provide meaningful advice to his or her patient, before turning to recent developments in syncope prognosis and considering a brief manifesto for the direction of travel for future research. This includes the need for patient group definition (for example, by age) rather than the current blanket view in prognosis studies; incorporation of outcomes that reflect the totality of the syncope experience, to include syncope recurrence and not just hard serious outcomes like mortality; information on the vast number of syncopal episodes that present via non-Emergency Department services; more information on outcomes in non-cardiac syncope; information on long-term outcomes in syncope, which is currently very limited; and finally data on whether knowledge of prognosis can influence outcomes, a consideration missing from the evidence base to date. When these factors are addressed and refined, we will be in a much better position to provide our patients and clinicians with an accurate prognosis that makes risk stratification and targeted investigation and management strategies based on it of benefit to them and the health care system as a whole.

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Authors and Affiliations

  1. Newcastle University Institute of Ageing and Institute of Population Health Science, Royal Victoria Infirmary, Newcastle upon Tyne, UK

    Steve W. Parry

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  1. Steve W. Parry
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Editors and Affiliations

  1. Faint & Fall Programme, IRCCS Istituto Auxologico Italiano Ospedale San Luca, Piazzale Brescia, Milano, Italy

    Michele Brignole

  2. University of Minnesota, MMC 508, Minneapolis, MN, USA

    David G. Benditt

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Parry, S.W. (2020). Prognosis of Syncope Across the Diagnostic Spectrum. In: Brignole, M., Benditt, D. (eds) Syncope. Springer, Cham. https://doi.org/10.1007/978-3-030-44507-2_3

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  • DOI: https://doi.org/10.1007/978-3-030-44507-2_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-44506-5

  • Online ISBN: 978-3-030-44507-2

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