Neurocardiogenic Syncope: Sensitivity and Specificity

Introduction:

Versus Ischemic Stroke. See also Subarachnoid Hemorrhage which shares some of the same findings (i.e. when intraparenchymal blood crosses into the subarachnoid space).

Great review of many findings (not all listed here): JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

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Tags: Cardiac Problem Neurologic Tag this Diagnosis.

Differential Diagnoses include: Stroke, Syncope

Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
Patients with syncope	33%	J Am Coll Cardiol 2001 Jun 1;37(7):1921-8. PMID 11401133
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The sensitivity and specificity of findings for Neurocardiogenic Syncope are listed below. See the left navigation bar to change the display.

Stroke

Finding	Sensitivity	Specificity	Comments, Study
Acute Onset	44%	32%	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Alert	23%	31%	i.e. as opposed to drowsy or comatose Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Atrial Fibrillation	2%	82%	on EKG Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Carotid Bruit	1%	93%	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Clinical diagnosis	76%	88%	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Coma	35%	94%	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Headache	46%	82%	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Hypertension	48%	89%	diastolic > 110mmHg Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Kernig or Brudzinski Sign	15%	98%	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Neck Stiffness	20%	97%	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Prior TIA	7%	79%	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Seizure	9%	98%	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Xanthochromia	71%	95%	(in CSF) Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Syncope

Tilt Table Test

75%

55%

resulting in syncope after isoproterenol administration

Study: Ann Intern Med 1992 Mar 1;116(5):358-63. PMID 1736767