Syncope in acute pulmonary embolism.

BACKGROUND: Syncope is a possible but little known presenting manifestation of acute pulmonary embolism (PE). The importance of syncope at the presentation of acute PE is not known. OBJECTIVES: To report the frequency and to establish the prognostic significance of syncope at the presentation of acute PE. METHODS: A retrospective review of the records of 154 consecutive patients admitted to an Internal Medicine service with acute PE. RESULTS: Fourteen patients with acute PE (9.1%) had syncope at presentation. Epidemiological and clinical characteristics (including respiratory failure, right heart failure and arterial hypotension), and hospital mortality were similar in patients with or without syncope. CONCLUSIONS: Syncope is not an uncommonly presenting manifestation of acute PE. Patients with acute PE and syncope have similar characteristics to those without syncope. Syncope does not seem to determine a poor prognosis.