There are more than 1.2 million annual events of syncope in the United States that lead to an emergency department visit, resulting in 440,000 admissions and $2.4 billion in yearly hospital costs. Patients without a clear cause of syncope are frequently admitted for diagnostic testing. However, current practice is characterized by high variation, low diagnostic yield, exorbitant costs, and unclear improvement in outcomes.
To address these challenges, the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) Syncope Guideline provides evidence-based recommendations.1 The multidisciplinary writing committee included an emergency medicine representative, and the final recommendations were endorsed by ACEP and the Society for Academic Emergency Medicine. Specific recommendations relevant to emergency physicians are summarized below.