During the past 20 years, a great deal has been learned about the evaluation,
management, and prognosis of syncope. Studies from the 1980s showed that for
approximately half of patients with syncope, the cause could not be established
using diagnostic tests widely available at the time.1 Studies
of risk stratification showed that the most important predictor of a poor
outcome was underlying structural heart disease, including abnormalities detected
on electrocardiogram.2,3 These
findings prompted investigators to devise new diagnostic tests and to propose
alternative strategies for managing syncope.
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