Emergency Physicians Monthly - April 19, 2017 - By Pines J and Rezaie S
"The PESIT trial deconstructed
Syncope is a familiar complaint for emergency physicians, accounting for 1-3% of ED visits. In general, the causes are mostly benign and self-limited; however, sometimes syncope can be a symptom of a more serious condition, such as acute coronary syndrome, malignant arrhythmia, or even pulmonary embolism (PE). Nevertheless, the ED diagnostic evaluation of syncope is often less than gratifying. A small percentage are diagnosed with something serious, while a larger group with negative ED work-ups are still thought to be high-risk and admitted for further observation and work-up. Unfortunately, there is no real gold standard test or validated decision instruments for syncope..."