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March 29, 2022CureusOpen Access

HUTT outperforms ECG for syncope evaluation, identifying the etiology in ~74% of cases.

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Why the study?

The study was designed to evaluate the clinical profile of patients with syncope and assess the usefulness of various clinical tests to determine the diagnosis and etiology of syncope.

What is the diagnostic yield of various clinical investigations in patients presenting with syncope?

Population

90 consecutive patients aged ≥ 12 years presenting with syncope

Design

Cross-sectional, observational study

Key result

Head-up tilt table testing (HUTT) had the highest diagnostic yield, identifying the etiology of syncope in 74% of cases, whereas ECG determined the etiology in 8% of cases.

Authors

RURajesh Bhat UppoorKPKashyap Patel

Discussion

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Overview

Supports targeted HUTT after initial ECG in syncope; hypothesis-generating, leaves open prospective validation before practice change.

Study Design

Type

Cross-Sectional (n=90)

Multicenter

No

Structured PICO

What is the diagnostic yield of various clinical investigations in patients presenting with syncope?

P
Population
90 consecutive patients (aged ≥ 12 years) presenting with syncope, 45% male.
I
Intervention
Various clinical investigations including history, physical examination, ECG, echocardiography, Holter monitoring, head-up tilt table test (HUTT), treadmill test, CT/MRI brain, EEG, carotid sinus massage, coronary angiography, electrophysiological study, and carotid Doppler ultrasound.
O
Outcome
Diagnostic yield and etiology of syncope.

Initial evaluation of syncope should focus on history, physical examination, and ECG to guide further high-yield testing and reduce diagnostic costs.

Limitations

  • Observational, single-center nature
  • Small number of enrolled patients
  • Factors that might have affected the attending physician's decision on the order of some tests were not considered

Cite This Study

Uppoor et al. (2022) conducted a cross-sectional in Syncope (n=90). Diagnostic investigations (ECG, Holter, HUTT, etc.) was evaluated on Diagnostic yield of various clinical investigations. Head-up tilt table testing (HUTT) had the highest diagnostic yield, identifying the etiology of syncope in 74% of cases, whereas ECG determined the etiology in 8% of cases.

synapsesocial.com/papers/6a0864bbab15ea61dee8d02fhttps://doi.org/10.7759/cureus.23596
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1CLINICAL GUIDELINE: Diagnosing Syncope: Part 1: Value of History, Physical Examination, and Electrocardiography1997 · 446 citations
  2. 2A prospective study of the standardized diagnostic evaluation of syncope2011 · 38 citations
  3. 3Evaluation and Management of the Patient With Syncope1992 · 229 citations
  4. 4Evaluation and management of the patient with syncope1992 · 37 citations
  5. 5Syncope: Current Diagnostic Evaluation and Management1990 · 214 citations