Resumen

MOHAWECHE¹, R et al. Utilidad de la Historia Clínica en la evaluación del paciente con Síncope. AVFT [online]. 2003, vol.22, n.2, pp.142-152. ISSN 0798-0264.

ABSTRACT Syncope is a very frequent community health problem and it represents approximately 3% to 5% of all consultations in emergency rooms and 1% to 3% of all hospitalizations. According to the data obtained in the Ambulatory Electrocardiograph Unit in the Hospital Universitario de Caracas (Caracas University Hospital), syncope represents 8% of the requests for patient evaluations that the Unit receives. Determining the cause of the syncope is usually a very difficult task for both physician and patient. Objectives: To prove that through the medical interview, physical examination and EKG a correct diagnostic impression can be established in most patients. Methods: A retrospective cohort study was carried out with a population sample of 222 cases obtained from 1996 to 2001 in the Electrophysiology unit of the Cardiology Service in the Caracas University Hospital. Results: The most frequent syncope in our study was the NON-cardiogenic type (63,5%) in which the neurocardiogenic was the most represented (44,59%). The etiology of syncope was not found in only 10,81% of all cases. Cardiac originated syncope is more frequent in patients of >40 years. Non-cardiogenic syncope is more frequent in the <40 years of age group (2,2 times more likely than between 16-24 years of age). The main premonitory symptoms are nausea, vomiting, paleness, cold, heat, sweating and pain; it is uncommon to find abnormalities in the physical cardiovascular examination and an abnormal electrocardiogram; co morbidity such as systemic arterial hypertension and valvulopathies, among others, can be found, but may not be the cause of syncope. The results of this study prove that clinical history can differentiate patients with cardiac and non-cardiac syncope with reasonable accuracy.

Palabras clave : Syncope; Orthostatism test; Cardiogenic; Neurocardiogenic; Situational.