What is the role of electrocardiography in the workup of syncope?

Updated: Jan 13, 2017
  • Author: Rumm Morag, MD, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

Obtain a standard 12-lead electrocardiogram (ECG) in patients with syncope. This is a level A recommendation in the 2007 American College of Emergency Physicians (ACEP) consensus guidelines for syncope. [2] ECG is used in virtually every clinical decision rule for risk stratification.

Normal ECG findings are a good prognostic sign. ECG can be diagnostic for acute myocardial infarction (MI) or myocardial ischemia and can provide objective evidence of preexisting cardiac disease or dysrhythmia, such as Wolff-Parkinson-White syndrome, Brugada syndrome, atrial flutter, or atrioventricular (AV) blocks. [32]

Bradycardia, sinus pauses, nonsustained ventricular tachycardia and sustained ventricular tachycardia, and atrioventricular conduction defects occur with increasing frequency with age and are truly diagnostic only when they coincide with symptoms.


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