High-risk features-syncope

(admit w/ tele; JACC 2017;70:620; EHJ 2018;39:1883)

• Age >60 y, h/o CAD, HF/CMP, valvular or congenital heart dis., arrhythmias, FHx SCD
• Syncope c/w cardiac cause (⊖ prodrome, exertional, supine, trauma) or recurrent
• Complaint of chest pain or dyspnea; abnl VS, cardiac, pulm, or neuro exam; low Hct
• ECG suggesting conduction abnormality, arrhythmia, or ischemia; Pt w/ PPM/ICD
• Canadian Syncope Risk Score (CMAJ 2016;188:e289) stratifies from <1% to >20% risk of serious arrhythmias. If low-risk & no arrhythmia in ED × 2 h, 0.2% risk over 30 d.