Protocolo diagnóstico del síncope en urgencias

Transient loss of consciousness (TLC) is defined as a real or apparent loss of consciousness that is characterized by amnesia during the period of unconsciousness, anomalous motor control, a lack of response, and short duration. A detailed medical history in the initial evaluation of a patient with an episode of syncope is key. It must include a personal and family medical history; the circumstances prior to the episode; its characteristics; prodromal symptoms; and information regarding the episode, which are usually provided by a witness. The findings upon examination and results of additional tests are the final pieces of the diagnostic strategy that allow for establishing a diagnosis of reflex (neuromediated) syncope, syncope due to orthostatic hypertension, or syncope secondary to cardiovascular disease. There are a series of entities that progress with transient loss of consciousness that are not caused by transient cerebral hypoperfusion and which, therefore, must not be considered syncope. It is important to establish the differential diagnosis in the initial evaluation in the emergency department.