2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients with Syncope

The purpose of this ACC/AHA/HRS guideline is to provide contemporary, accessible, and succinct guidance on the management of adult and pediatric patients with suspected syncope. This guideline is intended to be a practical document for cardiologists, arrhythmia specialists, neurologists, emergency physicians, general internists, geriatric specialists, sports medicine specialists, and other healthcare professionals involved in the care of this very large and heterogeneous population. It is not a review of physiology, pathophysiology, or mechanisms of underlying conditions associated with syncope. The nature of syncope as a symptom required that the writing committee consider numerous conditions for which it can be a symptom, and as much as possible, the writing group has addressed the involvement of syncope only as a presenting symptom. Because of the plausible association of syncope and sudden cardiac death (SCD) in selected populations, this document discusses risk stratification and prevention of SCD when appropriate.

The guideline addresses the management of syncope with the patient as a focus, rather than larger aspects of health services, such as syncope management units. The goals of the present guideline are as follows:

• To define syncope as a symptom, with different causes, in different populations and circumstances.
• To provide guidance and recommendations on the evaluation and management of patients with suspected syncope in the context of different clinical settings, specific causes, or selected circumstances.
• To identify key areas in which knowledge is lacking, to foster future collaborative research opportunities and efforts.