Do Orthostatic Vital Signs Have Utility in the Evaluation of Syncope?

<p><b>BACKGROUND: </b>Syncope is a common presentation in the emergency department (ED). The differential diagnosis is long and includes benign conditions as well as acute life threats, such as dysrhythmias or pulmonary embolism.</p>

<p><b>OBJECTIVE: </b>The specific goals of this review are twofold: 1) to define the diagnostic utility of orthostatic vital signs (OVS) as a test for orthostatic syncope, and 2) to determine whether OVS help diagnose or exclude life-threatening causes of syncope in ED patients.</p>

<p><b>METHODS: </b>Three prospective cohort studies plus 2017 national guidelines for syncope management were identified, reviewed, and critically appraised.</p>

<p><b>RESULTS: </b>This literature review found that orthostatic hypotension is common among ED patients with syncope and is often diagnosed as the cause of syncope.</p>

<p><b>CONCLUSIONS: </b>OVS measurements do not, in isolation, reliably diagnose or exclude orthostatic syncope, nor do they appear to have value in ruling out life-threatening causes of syncope.</p>