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Minerva Cardioangiologica 2000 March;48(3):69-78


language: English, Italian

Long-term follow-up after syncope. A group of 183 patients observed for 5 years

Racco F., Sconocchini C., Alesi C., Zappelli L., Pratillo G.


Background. To determine the incidence of recurrent syncope and mortality rate in a group of patients hospitalized for syncope.
Methods. A 5 years follow-up of 183 patients hospitalized for syncope. A collaborative study between the Departments of Cardiology and Neurology.
Results. The etiological diagnosis of syncope was the following: unknown causes 21.86%, cardiovascular causes 72.67%, non-cardiovascular cause 5.46%. The general mortality rate was 26.77% (51.94% in those aged >=70 years, 8.49% in <70 years). The mortality rate of syncope of unknown causes was 30% among all patients (61.11% in those aged >=70 years and 4.54% <70 years). Syncope of cardiac cause (prevalenty arrhythmias) and syncope of iatrogenic cause had a high mortality rate (respectively 63.33% and 42.10%); both in young people (28.53%, 26.53%) and in old people (66.66%, 50%). Syncope of reflex cause has a mortality rate of 5.79% (4/69) among all patients (14.28% in those aged >= 70 years, 3.63 in < 70 years).
Age, arterial hypertension, ischemic heart disease and cerebrovascular events are significantly associated with mortality rate. Recurren-ces were quite common: 24.59% of all patients (45/183); 29/45 syncope (64.44%) were observed in the first year of follow-up with a prevalence for patients with a syncope of reflex cause (26.09%) and for those with a syncope of unknown cause (37.56%). Recur-rences were less common among patients with syncope of cardiac cause, however more frequent during the first year of follow-up, with an increased risk of mortality.
Conclusions. A. The cause of syncope is most frequently established on the basis of history and clinical examination. B. A collaboration between Departments with a common interest for this pathology is recommended. C. Cardiac syncope has the worst prognosis and therefore needs recurrent clinialc examinations and prompt treatment. D. Syncope itself is not a risk factor for increased overall and cardiac mortality or cardiovascular events. E. Underlying diseases such as hypertension, ischemic heart diseases, congestive heart failure, cerebrovascular events are the major risk factors for mortality.

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