Prognosis-syncope

(Ann Emerg Med 1997;29:459; NEJM 2002;347:878)

• 22% overall recurrence rate if idiopathic, else 3% recurrence
• Cardiac syncope has poor prognosis (20–40% 1-y SCD rate); vasovagal good prognosis
• Unexplained syncope w/ 1.3-fold ↑ in mort., but noncardiac or unexplained syncope w/ nl ECG, no h/o VT, no HF, age <45 → low recurrence rate and <5% 1-y SCD rate
• ✓ state driving laws and MD reporting requirements. Consider appropriateness of Pt involvement in exercise/sport, operating machinery, high-risk occupation (eg, pilot).