8. Revista Salud Bosque - Cosecha
Syncope: Diagnostic approach for the primary care physician
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Resumen
Introduction: Syncope is a transient loss of consciousness due to cerebral hypoperfusion that recovers spontaneously. It is characterized by a decrease in blood pressure that results in reduced cerebral blood flow and can be classified into three groups: reflex, cardiogenic, and secondary to orthostatic hypotension. The diagnosis is based on a thorough medical history and physical examination, and paraclinical tests aid in the differential diagnosis. It occurs in 50% of the population at some point in life with two notable peaks: one between 10 and 30 years, generally benign, and another in people over 65, indicative of organic problems. Treatment focuses on stratifying risk and determining the underlying mechanism to take appropriate action. This study focuses on reviewing evidence-based recommendations for the diagnosis of syncope and highlights the importance of accurate assessment in potentially serious cases. Methodology: A search of the scientific literature was carried out in the databases of PubMed/Medline, Scielo and LILACS. Results and discussion: In international studies, it has been observed that syncope affects 9.5 out of every 1000 people per year. In our country, a population that sought medical attention due to syncope episodes was studied and the results revealed that the average age of the patients was 58 years with 46.5% women. In addition, it was found that 41.6% had high blood pressure and 21% had a history of heart disease. 75% of the cases were classified as non-cardiac syncope, 23% as cardiac syncope, and 2% had no identifiable cause. Conclusion: Syncope is the manifestation of a variety of underlying disorders and identifying those patients with suspected cardiac pathologies is important to provide specialized medical care as a priority. It is essential to highlight the importance of risk stratification as it allows an adequate diagnostic approach and implies the performance of more specific tests for high-risk patients and the implementation of adequate treatment aimed at the underlying cause.