Syncope Patients with a Normal ECG Are Unlikely to Have Structural Heart Disease

Although the differential diagnoses for syncope are myriad, most patients who present with syncope and are evaluated in an emergency department (ED) observation unit are discharged with no diagnosis and no identified cause of the syncopal episode. In a retrospective chart review of 323 consecutive patients admitted to a single ED observation unit after a syncopal episode, researchers evaluated the utility of structural evaluation of the heart by echocardiography.

Overall, 294 patients (91%) underwent echocardiography (transthoracic in 270, stress in 24). Of 267 patients who presented with normal electrocardiogram (ECG) results, 235 underwent transthoracic echocardiography and none had structural heart disease identified on echocardiogram. On…