After the Pulmonary Embolism in Syncope Italian Trial (PESIT) showed a 17% prevalence
of acute pulmonary embolism (APE) in patients hospitalized with first syncope [
[1]
], multiple consequent studies and meta-analysis revealed this prevalence to be <3%
[
2
,
3
,
4
], thereby, discouraging the adoption of a routine protocol for excluding APE in such
instance. While we definitely agree from our experience that the prevalence of APE
among all cases presenting with syncope is extremely low (<1% in the Costantino Study
and meta-analysis by Oqab and colleagues), we still advocate that clinicians maintain
a reasonable index of suspicion for diagnosing APE especially in cases presenting
with syncope.- Oqab Z.
- Ganshorn H.
- Sheldon R.
Prevalence of pulmonary embolism in patients presenting with syncope. A systematic
review and meta-analysis.
Am J Emerg Med. 2017; https://doi.org/10.1016/j.ajem.2017.09.015
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References
- Prevalence of pulmonary embolism among patients hospitalized for syncope.N Engl J Med. 2016; 375: 1524-1531
- Pulmonary embolism and deep venous thrombosis in patients hospitalized with syncope: a multicenter cross-sectional study in Toronto, Ontario, Canada.JAMA Intern Med. 2017; 177: 1046-1048
- Prevalence of pulmonary embolism in patients with syncope.in: JAMA Intern Med. 2018
- Prevalence of pulmonary embolism in patients presenting with syncope. A systematic review and meta-analysis.Am J Emerg Med. 2017; https://doi.org/10.1016/j.ajem.2017.09.015
- Syncope on presentation is a surrogate for submassive and massive acute pulmonary embolism.Am J Emerg Med. 2018; 36: 297-300
Article Info
Publication History
Published online: February 27, 2018
Accepted:
February 26,
2018
Received:
February 11,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
