Physical injuries caused by a transient loss of consciousness: main clinical characteristics of patients and diagnostic contribution of carotid sinus massage

Aims To evaluate the prevalence and the characteristics of secondary trauma among patients referred to the emergency department (ED) for a transient loss of consciousness (TLOC). Methods and results Over a 24 months period, all the patients referred to our ED for a TLOC were evaluated according to t...

Full description

Saved in:
Bibliographic Details
Published in:European heart journal 2008-03, Vol.29 (5), p.618-624
Main Authors: Bartoletti, Angelo, Fabiani, Plinio, Bagnoli, Luciano, Cappelletti, Carlo, Cappellini, Marco, Nappini, Gino, Gianni, Roberto, Lavacchi, Alessandro, Santoro, Giovanni Maria
Format: Article
Language:English
Subjects:
Carotid sinus massage
Emergency Service, Hospital - statistics & numerical data
Female
Heart Massage - methods
Humans
Male
Middle Aged
Patient Admission - statistics & numerical data
Physical injury
Syncope
Syncope - complications
Syncope - etiology
Transient loss of consciousness
Wounds and Injuries - etiology
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aims To evaluate the prevalence and the characteristics of secondary trauma among patients referred to the emergency department (ED) for a transient loss of consciousness (TLOC). Methods and results Over a 24 months period, all the patients referred to our ED for a TLOC were evaluated according to the ESC Guidelines on Syncope and enrolled in the study. Among 1253 consecutive patients with TLOC (1114 with a true syncope and 139 with a non-syncopal condition) 365 (29.1%) reported a trauma, in 59 cases (4.7%) severe. The frequency and the characteristics of trauma did not differ among the two main categories of TLOC. Out of 54 patients with syncope and a severe trauma, 20 (37%) had a definite diagnosis after a guidelines-based initial evaluation, and further 17 (31.5%) during the hospital course. Among these latter, carotid sinus syndrome was by far the most common diagnosis. Conclusion Among patients referred to the ED for a TLOC secondary trauma is a common complication, whose characteristics are of little utility to discover the specific cause of the symptom. For older patients with syncope complicated by a severe trauma carotid sinus massage should be the first diagnostic manoeuvre to be undertaken after a non-diagnostic initial evaluation.
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehm563