Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Application of Syncope Guidelines in a Center with a trauma-focused triage
Session:
Posters (Sessão 3 - Écran 3) - Arrítmias 4 - Vários
Speaker:
Paulo Medeiros
Congress:
CPC 2022
Topic:
C. Arrhythmias and Device Therapy
Theme:
07. Syncope and Bradycardia
Subtheme:
07.6 Syncope and Bradycardia - Clinical
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Paulo Medeiros; Cátia Oliveira; Carla Pires; Rui Flores; Fernando Mané; Rodrigo Silva; Inês Conde; Carina Arantes; Sónia Magalhães; Adília Rebelo; Sérgia Rocha
Abstract
<p style="text-align:justify">INTRODUCTION: Syncope is a common issue in the emergency department (ED), and many hospitals lack a dedicated syncope unit to observe and evaluate these patients. When attending the ED, patients with syncope or presyncope may be initially referred to medical or surgical (trauma) areas, according to the overall presentation.</p> <p style="text-align:justify"><br /> AIM: To understand the differences in the approach and diagnostic workup of syncope and presyncope patients referred to medical vs. surgical (trauma) areas.</p> <p style="text-align:justify"><br /> METHODS: Single-center descriptive analysis and comparison of patients that implanted a permanent pacemaker (PM) in 2019 and had at least 1 visit to the ED in the previous year (not including the one that may have triggered the PM implantation). From an initial pool of 398 patients, 88 (22%) were included in the analyzed sample. Patients were divided in two groups: group 1 – medical area; group 2 – surgical area. Clinical history red flags included syncope preceded by palpitations or chest pain, syncope while standing/sitting or syncope without prodromes. Physical examination red flags included hypotension, bradycardia and presence of systolic murmur.</p> <p style="text-align:justify"><br /> RESULTS: Sixty-six percent (n=58) of pts were included in group 1 and 34% (n=30) in group 2. The groups were similar in terms of gender distribution and presence of comorbidities (hypertension, diabetes mellitus, dyslipidemia, smoking and chronic kidney disease). Median<br /> observation time in the ED was 5.5 hours (min 0.5 hours, max 24 hours). Thirty-three percent (n=19) of patients referred to the medical area had at least 1 clinical history red flag vs 57% (n=17) of those referred to the surgical area, and this different was statically significant (X<sup>2</sup>(1, N=88) = 4.67, p=0.031). The proportion of physical examination red flags was similar between the 2 groups. However, 86% (n=50) of group 1 patients performed an ECG vs 41% (n=9) of group 2, with statistical significance (X<sup>2 </sup>(1, N=88) = 28.27, p<0.001). Additionally, 34% (n=20) of group 1 patients were referred to observation by a cardiologist in the ED vs 11% (n=3) of group 2 pts (X<sup>2 </sup>(1, N=88) = 6.36, p=0.012). Finally, 45% (n=26) of group 1 patients had a scheduled cardiology appointment by discharge, while only 11% of group 2 patients did, with statistical significance (X<sup>2 </sup>(1, N=88) = 10.85, p=0.001).</p> <p style="text-align:justify"><br /> CONCLUSION: Our results reveal an important issue in syncope and presyncope patients triage at the ED. Considering that all the patients ended up implanting a permanent PM, the proportion of these that were observed by a cardiologist at the ED or were referred to a future appointment was remarkably low. Also, the approach of patients referred to the surgical area may have been more focused on the trauma itself than on the triggering event, which may explain the low percentage of requested ECGs. Although none of the triage areas had ideal results, surgical area observation was associated with a worse diagnostic workup and referral of syncope patients.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site