TY - JOUR
T1 - ACR Appropriateness Criteria® Syncope
AU - Kligerman, Seth J.
AU - Bykowski, Julie
AU - Hurwitz Koweek, Lynne M.
AU - Policeni, Bruno
AU - Ghoshhajra, Brian B.
AU - Brown, Michael D.
AU - Davis, Andrew M.
AU - Dibble, Elizabeth H.
AU - Johnson, Thomas V.
AU - Khosa, Faisal
AU - Ledbetter, Luke N.
AU - Leung, Steve W.
AU - Liebeskind, David S.
AU - Litmanovich, Diana
AU - Maroules, Christopher D.
AU - Pannell, Jeffrey S.
AU - Powers, William J.
AU - Villines, Todd C.
AU - Wang, Lily L.
AU - Wann, Samuel
AU - Corey, Amanda S.
AU - Abbara, Suhny
N1 - Publisher Copyright:
© 2021 American College of Radiology
PY - 2021/5
Y1 - 2021/5
N2 - Syncope and presyncope lead to well over one million emergency room visits in the United States each year. Elucidating the cause of syncope or presyncope, which are grouped together given similar etiologies and outcomes, can be exceedingly difficult given the diverse etiologies. This becomes more challenging as some causes, such as vasovagal syncope, are relatively innocuous while others, such as cardiac-related syncope, carry a significant increased risk of death. While the mainstay of syncope and presyncope assessment is a detailed history and physical examination, imaging can play a role in certain situations. In patients where a cardiovascular etiology is suspected based on the appropriate history, physical examination, and ECG findings, resting transthoracic echocardiography is usually considered appropriate for the initial imaging. While no imaging studies are considered usually appropriate when there is a low probability of cardiac or neurologic pathology, chest radiography may be appropriate in certain clinical situations. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
AB - Syncope and presyncope lead to well over one million emergency room visits in the United States each year. Elucidating the cause of syncope or presyncope, which are grouped together given similar etiologies and outcomes, can be exceedingly difficult given the diverse etiologies. This becomes more challenging as some causes, such as vasovagal syncope, are relatively innocuous while others, such as cardiac-related syncope, carry a significant increased risk of death. While the mainstay of syncope and presyncope assessment is a detailed history and physical examination, imaging can play a role in certain situations. In patients where a cardiovascular etiology is suspected based on the appropriate history, physical examination, and ECG findings, resting transthoracic echocardiography is usually considered appropriate for the initial imaging. While no imaging studies are considered usually appropriate when there is a low probability of cardiac or neurologic pathology, chest radiography may be appropriate in certain clinical situations. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
KW - AUC
KW - Appropriate Use Criteria
KW - Appropriateness Criteria
KW - Cardiovascular
KW - Echocardiogram
KW - Neurologic
KW - Presyncope
KW - Radiography
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U2 - 10.1016/j.jacr.2021.02.021
DO - 10.1016/j.jacr.2021.02.021
M3 - Article
C2 - 33958116
AN - SCOPUS:85104706257
SN - 1546-1440
VL - 18
SP - S229-S238
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
IS - 5
ER -