Usefulness of the Calgary Syncope Symptom Score for the diagnosis of vasovagal syncope in the elderly

Abstract

The CSSS has a lower sensitivity and specificity in an elderly population presenting with syncope compared to previously validated data in young adults, particularly in elderly patients with previous history of mild cardiovascular disease. A modified CSSS may be needed to improve specificity and sensitivity in this population.

2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

“…[495][496][497] Rehydration, whether by intravenous or oral formulation, should include sodium supplementation for more rapid recovery. 21 Fluid resuscitation is recommended for syncope secondary to both dehydration and exercise-associated hypotension. The latter is likely due to peripheral vasodilation and vasovagal physiology.…”

2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope

“…90–93 Generally, attempts at validation have not been conducted with patients as rigorously defined as in the derivation studies. 94,95 Although these scores report overall high degrees of accuracy, they likely require revision and validation in larger populations. Nonetheless, the scores serve as useful reminders of important diagnostic points, and they form reproducible criteria for entry into observational, genetic, and randomized, controlled interventional trials.…”

2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope

“…The evaluation of patients with syncope should include a full assessment of the longterm risk factors, including those listed in Table 5. 69,70,[72][73][74][84][85][86][87][88][89][90][91][92][93]95,97 IIb B-NR Use of risk stratification scores may be reasonable in the management of patients with syncope. 67,68,72,73,75,87,89,100,101 See Online Data Supplements 3 and 4.…”

“…Risk markers are summarized in Table 5. 64,[67][68][69][70][72][73][74][75][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96][97][98] The types of events, event rates, and study durations from investigations that estimated risk scores are summarized in Table 6. 64,65,76,81,87,89,92,97,99…”