Background: Syncope is fairly easily recognised as a brief loss of consciousness. Near-syncope (or presyncope), on the other hand, is a more nebulous phenomenon, both to patients and their doctors. It can be described as an episode of dizziness, feeling hot or cold, blurred vision, nausea, weakness, or a ‘funny turn’. It is generally believed that syncope is a more serious beast than near-syncope, but the current paper puts this idea to the test.

 

The paper: A prospective observational cohort study across 11 EDs, involving 3,581 patients aged >60 with syncope or near-syncope. The primary outcome was all-cause mortality or serious clinical event (cardiac arrhythmia, heart block, pacemaker insertion, MI, PCI, PE, stroke or subarachnoid haemorrhage) at 30 days. There was no significant difference in this outcome between the groups (syncope 18.2%, near-syncope 18.7%). (Annals of Emergency Medicine, December 2018)

 

The bottom line: Those patients who present with near-syncope should be investigated with as much care as those with syncope, because they have the same risk of death or serious clinical event.