Originally written: January 6, 2017

According to a study in the October 20, 2016, issue of the New England Journal of Medicine, surprisingly so, specifically 1 out of every 6 patients admitted for first-time syncope. It was found in 24% of patients who presented with syncope when no other cause was found and even 13% among those who had another potential cause.

Keep in mind that in the study of 560 patients most were older than 75 years. They were screened with a D-dimer blood test, and the diagnosis was confirmed with a CT angiogram of the chest or V/Q scanning.

Patients were identified at 11 hospitals in Italy over a 4-year period. Lead author is Paolo Prandoni. Comments by several experts varied from great skepticism to a feeling of being validated for similarly held beliefs. If the results can be validated, they will likely change clinical practice for elderly patients with syncope. Benefits of anticoagulation would outweigh risks of CT angiography.

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