syncope

DC Inst – Vasovagal Syncope

DC

You have been evaluated in the Emergency Department today for your syncopal episode. Your evaluation did not show evidence of medical conditions requiring emergent intervention at this time, however we recommend you follow up with your primary care provider for further testing as an outpatient.

Please follow up with your primary care doctor in 2-3 days.

Return to the ER immediately for worsening or uncontrolled symptoms, headache, chest pain, shortness of breath, persistent vomiting, vision changes, recurrent fainting, or for any other concerning symptoms.

Thank you for choosing us for your care.

SYNCOPE – Admit

MDM

This *** patient presents with symptoms consistent with syncope, most likely due to ***. Differential diagnosis includes ***reflex syncope (i.e. vasovagal syncope). Low suspicion for orthostatic syncope given lack of dehydration, no evidence of acute life threatening hemorrhage. Presentation not consistent with seizures given short time course, no postictal state, no seizure activity. Low suspicion for acute neurologic catastrophes to include ICH given lack of trauma, risk factors for bleeding diatheses. Low suspicion for vascular catastrophes to include PE, thoracic aortic dissection, AAA rupture. Presentation not consistent with acute life threatening arrhythmia, structural heart disease, electrical conduction abnormalities, or ACS (HEART score: ***). However, given age, cardiovascular risk factors, history & physical, will workup and admit to telemetry.

Plan: labs, troponin, CXR, EKG, serial reassessment