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Evaluation of Patients with Syncope in the Emergency Department: How to Adjust Pharmacological Therapy

Syncope Unit, Geriatric and Intensive Care Unit, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy
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Author to whom correspondence should be addressed.
Contributed equally to the paper.
Academic Editors: Franca Dipaola, Monica Solbiati and Emanuele Pivetta
Received: 3 May 2021 / Revised: 5 June 2021 / Accepted: 8 June 2021 / Published: 11 June 2021
(This article belongs to the Special Issue Syncope in the Emergency Department)
The rate of syncope in the Emergency Department ranges between 0.9 and 1.7%. Syncope is mostly related to a underlying reflex or orthostatic mechanism. A bradycardic or a hypotensive phenotype, may be identified. The latter is the most common and could be constitutional or drug induced. Consequently, obtaining an accurate drug history is an important step of the initial assessment of syncope. As anti-hypertensive medication might be responsible for orthostatic hypotension, managing hypertension in patients with syncope requires finding an ideal balance between hypotensive and cardiovascular risks. The choice of anti-hypertensive molecule as well as the therapeutic regimen and dosage, influences the risk of syncope. Not only could anti-hypertensive drugs have a hypotensive effect but opioids and psychoactive medications may also be involved in the mechanism of syncope. Proper drug management could reduce syncope recurrences and their consequences. View Full-Text
Keywords: syncope; orthostatic hypotension; hypotensive phenotype; hypotensive susceptibility; pharmacological therapy; drugs syncope; orthostatic hypotension; hypotensive phenotype; hypotensive susceptibility; pharmacological therapy; drugs
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MDPI and ACS Style

Rafanelli, M.; Testa, G.D.; Rivasi, G.; Ungar, A. Evaluation of Patients with Syncope in the Emergency Department: How to Adjust Pharmacological Therapy. Medicina 2021, 57, 603. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060603

AMA Style

Rafanelli M, Testa GD, Rivasi G, Ungar A. Evaluation of Patients with Syncope in the Emergency Department: How to Adjust Pharmacological Therapy. Medicina. 2021; 57(6):603. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060603

Chicago/Turabian Style

Rafanelli, Martina, Giuseppe D. Testa, Giulia Rivasi, and Andrea Ungar. 2021. "Evaluation of Patients with Syncope in the Emergency Department: How to Adjust Pharmacological Therapy" Medicina 57, no. 6: 603. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57060603

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