According to Amal Mattu, MD, FACEP, patients who present in an emergency department with syncope may be the lucky ones.

“Syncope and sudden cardiac death are oftentimes the same disease along the spectrum of how lucky you are,” said Dr. Mattu, professor of emergency medicine at the University of Maryland Medical Center in Baltimore. “If you don’t make the diagnosis, the next time the patient has a syncopal episode, [they] might not be lucky enough to wake up.”

In his session “Dysrhythmias and Syncope,” Dr. Mattu will focus mostly on syncope and will highlight six potential red flags emergency physicians need to look for on electrocardiograms (ECG): Wolff-Parkinson-White syndrome, prolonged QT, Brugada syndrome, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and atrial septal defect.

Dr. Mattu noted that all patients presenting with syncope should be given an ECG, as its value as a diagnostic tool is unrivaled for those patients.

“The ECG is definitely the most important test we get in patients that have syncope,” Dr. Mattu said. “There’s really no other lab test, X-ray, CT scan, Holter monitoring, or any other test at all that needs to be as routinely done…the ECG is so important.” 
Richard Quinn is a freelance writer in New Jersey.