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

Total Score
0
Low Risk
0.0% 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
Low 0% 0% 0% 0% 0% 0%

*All deaths include deaths secondary to an arrhythmic or non-arrhythmic serious condition