Neurocardiogenic Syncope: Likelihood Ratios

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 likelihood ratios of findings for Neurocardiogenic Syncope are listed below. See the left navigation bar to change the display.

Stroke

Finding	+LR	-LR	Comments, Study
Acute Onset	0.6	1.8	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Alert	0.3	2.5	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	0.1	1.2	on EKG Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Carotid Bruit	0.1	1.1	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Clinical diagnosis	6.3	0.3	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Coma	5.8	0.7	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Headache	2.6	0.7	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Hypertension	4.4	0.6	diastolic > 110mmHg Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Kernig or Brudzinski Sign	7.5	0.9	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Neck Stiffness	6.7	0.8	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Prior TIA	0.3	1.2	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Seizure	4.5	0.9	Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280
Xanthochromia	14.2	0.3	(in CSF) Study: JAMA 2010;303(22):2280-2286 http://jama.ama-assn.org/cgi/content/short/303/22/2280

Syncope

Tilt Table Test

1.7

0.5

resulting in syncope after isoproterenol administration

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