Canadian Syncope Risk Score Calculator
Clinical evaluation
Predisposition to vasovagal symptoms
Triggered by being in a warm crowded place, prolonged standing, fear, emotion, or pain
Heart disease history
CAD, CHF, valvular HD, cardiomyopathy, non-sinus rhythm or device implantation
Any systolic blood pressure reading in the emergency department <90 or >180 mmHg
Includes blood pressure values from triage until disposition from the emergency department
Investigations
Elevated troponin
>99th percentile of normal population
Abnormal QRS axis
<-30° or >100°
QRS duration >130 milliseconds
Corrected QT interval >480 milliseconds
Diagnosis in emergency department
Vasovagal or Reflex or Neurally mediated syncope
Based on evaluation and clinical impression in ED (Features include one or more of the following: vasovagal predisposition may be present; typically associated with a prodrome of diaphoresis, warmth, nausea/vomiting, or pallor; associated with hypotension or inappropriate bradycardia; often followed by fatigue; may be situational – e.g. micturition, cough)
Cardiac syncope
Based on evaluation and clinical impression in ED (Features include one or more of the following: syncope during exertion; preceded by palpitations; sudden with no prodrome; injuries suggesting sudden fall; family history of sudden death at young age; history of heart disease, ECG findings suggestive of structural heart disease or arrhythmic syncope)
Unexplained syncope
Based on evaluation and clinical impression in ED the patient does not fit into either of the above two categories – vasovagal or cardiac
* You must choose "Yes" for one of the 3 questions
under 'Diagnosis in Emergency Department'.
Total Score
-
-
- Risk
-% risk of 30-day serious adverse events
| Risk Category | All deaths* | Arrhythmic outcomes N (%) | Non-Arrhythmia N (%) | All outcomes N (%) | ||
|---|---|---|---|---|---|---|
| Death from unknown cause | Ventricular arrhythmia | Supraventricular/Atrial arrhythmia | ||||
| - | -% | -% | -% | -% | -% | -% |
*All deaths include deaths secondary to an arrhythmic or non-arrhythmic serious condition
