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| | [[Syncope]] is classified into three types: |
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| | * [[Cardiac]] |
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| | * [[Neurogenic]] |
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| | * [[Vasovagal syncope|vasovagal]] |
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| ! style="background: #FFFF00; width: 150px;" | Recomendacations !! style="background: #FFFF00; width: 150px;" | Class !! style="background: #FFFF00; width: 150px;" | Level !! style="background: #FFFF00; width: 150px;" | References
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| ! colspan="4" align="left" |History and clinical assessment
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| ! style="padding: 5px 5px; background: #FFFFE0; " align="left" |In all patients with suspected
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| AAS, pre-test probability
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| assessment is recommended,
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| according to the patient’s
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| condition, symptoms, and
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| clinical features.
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| | style="padding: 5px 5px; background: #90EE90;" align="center" |'''I'''
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| | style="padding: 5px 5px; background: #FFFFFF;" align="center" |'''B'''
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| | style="padding: 5px 5px; background: #FFFFE0;" align="center" |
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| ! colspan="4" align="left" | Laboratory testing
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| ! style="padding: 5px 5px; background: #FFFFE0; " align="left" |In case of suspicion of AAS,
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| the interpretation of
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| biomarkers should always be
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| considered along with the pretest
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| clinical probability.
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| | style="padding: 5px 5px; background: #FFFFE0;" align="center" |'''IIa'''
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| | style="padding: 5px 5px; background: #FFFFE0;" align="center" |'''B'''
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| ! style="padding: 5px 5px; background: #F5F5F5; " align="left" |In case of low clinical
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| probability of AAS, negative D-dimer
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| levels should be
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| considered as ruling out the
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| diagnosis.
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| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''IIa'''
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| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''C'''
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| ! style="padding: 5px 5px; background: #FFFFE0; " align="left" |In case of intermediate clinical
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| probability of AAS with a
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| positive (point-of-care) D-dimer
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| test, further imaging
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| tests should be considered.
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| | style="padding: 5px 5px; background: #FFFFE0;" align="center" |'''IIa'''
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| | style="padding: 5px 5px; background: #FFFFE0;" align="center" |'''B'''
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| ! style="padding: 5px 5px; background: #F5F5F5; " align="left" |In patients with high probability
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| (risk score 2 or 3) of AD,
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| testing of D-dimers is not
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| recommended.
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| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''III'''
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| | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''C'''
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| ! colspan="4" align="left" |Imaging
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| ! style="padding: 5px 5px; background: #F5F5F5; " align="left" |TTE is recommended as an
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| initial imaging investigation.
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| | style="padding: 5px 5px; background: #90EE90;" align="center" |'''I'''
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| !C
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| !
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| ! style="padding: 5px 5px; background: #F5F5F5; " align="left" |In unstabled patients with a
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| suspicion of AAS, the following
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| imaging modalities are
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| recommended according to
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| local availability and expertise:
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| !
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| !
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| !
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| |-
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| !TOE
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| | style="padding: 5px 5px; background: #90EE90;" align="center" |'''I'''
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| !C
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| !
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| |-
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| !CT
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| | style="padding: 5px 5px; background: #90EE90;" align="center" |'''I'''
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| !C
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| !
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| ! style="padding: 5px 5px; background: #F5F5F5; " align="left" |In stable patients with a
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| suspicion of AAS, the
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| following imaging modalities
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| are recommended (or should
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| be considered) according to
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| local availability and expertise:
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| !
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| !
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| !
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| |-
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| !CT
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| | style="padding: 5px 5px; background: #90EE90;" align="center" |'''I'''
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| !C
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| !
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| |-
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| !MRI
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| | style="padding: 5px 5px; background: #90EE90;" align="center" |'''I'''
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| !C
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| !
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| |-
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| !TOE
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| !IIa
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| !C
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| !
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| ! style="padding: 5px 5px; background: #F5F5F5; " align="left" |In case of initially negative
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| imaging with the persistence of
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| suspicion of AAS, repetitive
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| imaging (CT or MRI) is
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| recommended.
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| | style="padding: 5px 5px; background: #90EE90;" align="center" |'''I'''
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| !C
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| !
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| |-
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| ! style="padding: 5px 5px; background: #F5F5F5; " align="left" |Chest X-ray maybe
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| considered in cases of low
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| clinical probability of AAS.
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| !IIb
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| !C
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| !
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| |-
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| ! style="padding: 5px 5px; background: #F5F5F5; " align="left" |In case of uncomplicated
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| Type B AD treated medically,
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| repeated imaging (CT or
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| MRI)e during the first days is
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| recommended.
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| | style="padding: 5px 5px; background: #90EE90;" align="center" |'''I'''
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| !C
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| !
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| |} | |