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Syncope with High Risk Cardiac Characteristics

MedGen UID:
473896
•Concept ID:
C3272263
•
Finding

Definition

A sudden loss of consciousness with loss of postural tone not related to anesthesia with high risk characteristics. High risk characteristics include non-ischemic dilated cardiomyopathy, or ischemic heart disease with significant ventricular dysfunction, hypertrophic cardiomyopathy, Brugada Syndrome, or Long QT Syndrome. (ACC) [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVSyncope with High Risk Cardiac Characteristics

Professional guidelines

PubMed

Arrhythmic mitral valve prolapse and mitral annular disjunction: pathophysiology, risk stratification, and management.
Essayagh B, Sabbag A, El-Am E, Cavalcante JL, Michelena HI, Enriquez-Sarano M
Eur Heart J 2023 Sep 1;44(33):3121-3135. doi: 10.1093/eurheartj/ehad491. PMID: 37561995
Characterization and Management of Arrhythmic Events in Young Patients With Brugada Syndrome.
Michowitz Y, Milman A, Andorin A, Sarquella-Brugada G, Gonzalez Corcia MC, Gourraud JB, Conte G, Sacher F, Juang JJM, Kim SH, Leshem E, Mabo P, Postema PG, Hochstadt A, Wijeyeratne YD, Denjoy I, Giustetto C, Mizusawa Y, Huang Z, Jespersen CH, Maeda S, Takahashi Y, Kamakura T, Aiba T, Arbelo E, Mazzanti A, Allocca G, Brugada R, Casado-Arroyo R, Champagne J, Priori SG, Veltmann C, Delise P, Corrado D, Brugada J, Kusano KF, Hirao K, Calo L, Takagi M, Tfelt-Hansen J, Yan GX, Gaita F, Leenhardt A, Behr ER, Wilde AAM, Nam GB, Brugada P, Probst V, Belhassen B
J Am Coll Cardiol 2019 Apr 16;73(14):1756-1765. doi: 10.1016/j.jacc.2019.01.048. PMID: 30975291
A risk score to predict need for treatment for upper-gastrointestinal haemorrhage.
Blatchford O, Murray WR, Blatchford M
Lancet 2000 Oct 14;356(9238):1318-21. doi: 10.1016/S0140-6736(00)02816-6. PMID: 11073021

Recent clinical studies

Etiology

Arrhythmic mitral valve prolapse and mitral annular disjunction: pathophysiology, risk stratification, and management.
Essayagh B, Sabbag A, El-Am E, Cavalcante JL, Michelena HI, Enriquez-Sarano M
Eur Heart J 2023 Sep 1;44(33):3121-3135. doi: 10.1093/eurheartj/ehad491. PMID: 37561995
Acute Pulmonary Embolism: A Review.
Freund Y, Cohen-Aubart F, Bloom B
JAMA 2022 Oct 4;328(13):1336-1345. doi: 10.1001/jama.2022.16815. PMID: 36194215
Clinical Outcomes and Response to Vericiguat According to Index Heart Failure Event: Insights From the VICTORIA Trial.
Lam CSP, Giczewska A, Sliwa K, Edelmann F, Refsgaard J, Bocchi E, Ezekowitz JA, Hernandez AF, O'Connor CM, Roessig L, Patel MJ, Pieske B, Anstrom KJ, Armstrong PW; VICTORIA Study Group
JAMA Cardiol 2021 Jun 1;6(6):706-712. doi: 10.1001/jamacardio.2020.6455. PMID: 33185650Free PMC Article
Brugada syndrome.
Jellins J, Milanovic M, Taitz DJ, Wan SH, Yam PW
Hong Kong Med J 2013 Apr;19(2):159-67. PMID: 23535677
A risk score to predict need for treatment for upper-gastrointestinal haemorrhage.
Blatchford O, Murray WR, Blatchford M
Lancet 2000 Oct 14;356(9238):1318-21. doi: 10.1016/S0140-6736(00)02816-6. PMID: 11073021

Diagnosis

Ejection Fraction, Biomarkers, and Outcomes and Impact of Vericiguat on Outcomes Across EF in VICTORIA.
Butler J, Zheng Y, Khan MS, Bonderman D, Lund LH, deFilippi CR, Blaustein RO, Ezekowitz JA, Freitas C, Hernandez AF, O'Connor CM, Voors AA, Westerhout CM, Lam CSP, Armstrong PW; VICTORIA Study Group
JACC Heart Fail 2023 May;11(5):583-592. Epub 2023 Apr 12 doi: 10.1016/j.jchf.2022.12.014. PMID: 37137660
Acute Pulmonary Embolism: A Review.
Freund Y, Cohen-Aubart F, Bloom B
JAMA 2022 Oct 4;328(13):1336-1345. doi: 10.1001/jama.2022.16815. PMID: 36194215
Catecholaminergic polymorphic ventricular tachycardia, an update.
Pérez-Riera AR, Barbosa-Barros R, de Rezende Barbosa MPC, Daminello-Raimundo R, de Lucca AA Jr, de Abreu LC
Ann Noninvasive Electrocardiol 2018 Jul;23(4):e12512. Epub 2017 Oct 19 doi: 10.1111/anec.12512. PMID: 29048771Free PMC Article
Brugada syndrome.
Jellins J, Milanovic M, Taitz DJ, Wan SH, Yam PW
Hong Kong Med J 2013 Apr;19(2):159-67. PMID: 23535677
A risk score to predict need for treatment for upper-gastrointestinal haemorrhage.
Blatchford O, Murray WR, Blatchford M
Lancet 2000 Oct 14;356(9238):1318-21. doi: 10.1016/S0140-6736(00)02816-6. PMID: 11073021

Therapy

Ejection Fraction, Biomarkers, and Outcomes and Impact of Vericiguat on Outcomes Across EF in VICTORIA.
Butler J, Zheng Y, Khan MS, Bonderman D, Lund LH, deFilippi CR, Blaustein RO, Ezekowitz JA, Freitas C, Hernandez AF, O'Connor CM, Voors AA, Westerhout CM, Lam CSP, Armstrong PW; VICTORIA Study Group
JACC Heart Fail 2023 May;11(5):583-592. Epub 2023 Apr 12 doi: 10.1016/j.jchf.2022.12.014. PMID: 37137660
Acute Pulmonary Embolism: A Review.
Freund Y, Cohen-Aubart F, Bloom B
JAMA 2022 Oct 4;328(13):1336-1345. doi: 10.1001/jama.2022.16815. PMID: 36194215
Clinical Outcomes and Response to Vericiguat According to Index Heart Failure Event: Insights From the VICTORIA Trial.
Lam CSP, Giczewska A, Sliwa K, Edelmann F, Refsgaard J, Bocchi E, Ezekowitz JA, Hernandez AF, O'Connor CM, Roessig L, Patel MJ, Pieske B, Anstrom KJ, Armstrong PW; VICTORIA Study Group
JAMA Cardiol 2021 Jun 1;6(6):706-712. doi: 10.1001/jamacardio.2020.6455. PMID: 33185650Free PMC Article
Going Beyond the Guidelines in Individualising the Use of Antihypertensive Drugs in Older Patients.
Scott IA, Hilmer SN, Le Couteur DG
Drugs Aging 2019 Aug;36(8):675-685. doi: 10.1007/s40266-019-00683-8. PMID: 31175614
Catecholaminergic Polymorphic Ventricular Tachycardia.
Wall JJ, Iyer RV
Pediatr Emerg Care 2017 Jun;33(6):427-431. doi: 10.1097/PEC.0000000000001156. PMID: 28570361

Prognosis

High-risk features and predictors of unexplained syncope in the young SCD-SOS cohort.
Carrington M, Pais J, Brás D, Creta A, Teixeira R, Gonçalves L, Providência R
J Cardiovasc Electrophysiol 2021 Oct;32(10):2737-2745. Epub 2021 Aug 21 doi: 10.1111/jce.15204. PMID: 34379354
Outcomes in syncope research: a systematic review and critical appraisal.
Solbiati M, Bozzano V, Barbic F, Casazza G, Dipaola F, Quinn JV, Reed MJ, Sheldon RS, Shen WK, Sun BC, Thiruganasambandamoorthy V, Furlan R, Costantino G
Intern Emerg Med 2018 Jun;13(4):593-601. Epub 2018 Jan 18 doi: 10.1007/s11739-018-1788-z. PMID: 29349639
Brugada syndrome.
Jellins J, Milanovic M, Taitz DJ, Wan SH, Yam PW
Hong Kong Med J 2013 Apr;19(2):159-67. PMID: 23535677
Congenital long QT syndrome.
Crotti L, Celano G, Dagradi F, Schwartz PJ
Orphanet J Rare Dis 2008 Jul 7;3:18. doi: 10.1186/1750-1172-3-18. PMID: 18606002Free PMC Article
A risk score to predict need for treatment for upper-gastrointestinal haemorrhage.
Blatchford O, Murray WR, Blatchford M
Lancet 2000 Oct 14;356(9238):1318-21. doi: 10.1016/S0140-6736(00)02816-6. PMID: 11073021

Clinical prediction guides

Clinical characteristics and presentation form in patients with venous thromboembolism and negative or weakly positive D-dimer.
Demelo-Rodríguez P, López-Rubio M, Oblitas CM, Lago-Rodríguez MO, Gálvez-Rojas-Martín L, Galeano-Valle F
Med Clin (Barc) 2023 Mar 24;160(6):253-257. Epub 2022 Oct 12 doi: 10.1016/j.medcli.2022.07.018. PMID: 36241575
Acute Pulmonary Embolism: A Review.
Freund Y, Cohen-Aubart F, Bloom B
JAMA 2022 Oct 4;328(13):1336-1345. doi: 10.1001/jama.2022.16815. PMID: 36194215
High-risk features and predictors of unexplained syncope in the young SCD-SOS cohort.
Carrington M, Pais J, Brás D, Creta A, Teixeira R, Gonçalves L, Providência R
J Cardiovasc Electrophysiol 2021 Oct;32(10):2737-2745. Epub 2021 Aug 21 doi: 10.1111/jce.15204. PMID: 34379354
Catecholaminergic polymorphic ventricular tachycardia, an update.
Pérez-Riera AR, Barbosa-Barros R, de Rezende Barbosa MPC, Daminello-Raimundo R, de Lucca AA Jr, de Abreu LC
Ann Noninvasive Electrocardiol 2018 Jul;23(4):e12512. Epub 2017 Oct 19 doi: 10.1111/anec.12512. PMID: 29048771Free PMC Article
A risk score to predict need for treatment for upper-gastrointestinal haemorrhage.
Blatchford O, Murray WR, Blatchford M
Lancet 2000 Oct 14;356(9238):1318-21. doi: 10.1016/S0140-6736(00)02816-6. PMID: 11073021

Recent systematic reviews

Role of Intravascular Ultrasound in Pulmonary Embolism Patients Undergoing Mechanical Thrombectomy: A Systematic Review.
Desai R, Raval M, Adompreh-Fia KS, Nagarajan JS, Ghadge N, Vyas A, Jain A, Paul TK, Sachdeva R, Kumar G
Tomography 2023 Jul 14;9(4):1393-1407. doi: 10.3390/tomography9040111. PMID: 37489479Free PMC Article
Effect of ICD implantation on cardiovascular outcomes in patients with cardiac amyloidosis: A systematic review and meta-anaylsis.
Halawa A, Woldu HG, Kacey KG, Alpert MA
J Cardiovasc Electrophysiol 2020 Jul;31(7):1749-1758. Epub 2020 Jun 13 doi: 10.1111/jce.14541. PMID: 32391952
Outcomes in syncope research: a systematic review and critical appraisal.
Solbiati M, Bozzano V, Barbic F, Casazza G, Dipaola F, Quinn JV, Reed MJ, Sheldon RS, Shen WK, Sun BC, Thiruganasambandamoorthy V, Furlan R, Costantino G
Intern Emerg Med 2018 Jun;13(4):593-601. Epub 2018 Jan 18 doi: 10.1007/s11739-018-1788-z. PMID: 29349639
Prognostic value of cardiac biomarkers in the risk stratification of syncope: a systematic review.
Thiruganasambandamoorthy V, Ramaekers R, Rahman MO, Stiell IG, Sikora L, Kelly SL, Christ M, Claret PG, Reed MJ
Intern Emerg Med 2015 Dec;10(8):1003-14. Epub 2015 Oct 23 doi: 10.1007/s11739-015-1318-1. PMID: 26498335
Systematic review: comparative effectiveness of angiotensin-converting enzyme inhibitors or angiotensin II-receptor blockers for ischemic heart disease.
Baker WL, Coleman CI, Kluger J, Reinhart KM, Talati R, Quercia R, Phung OJ, White CM
Ann Intern Med 2009 Dec 15;151(12):861-71. doi: 10.7326/0003-4819-151-12-200912150-00162. PMID: 20008762

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