EGSYS calculator

What is EGSYS Score for Syncope?

Evaluation of Guidelines in Syncope Study (EGSYS) helps determine the likelihood of syncope being cardiac or noncardiac. This predictive model is quite effective for risk stratification in syncope patients.

EGSYS is used for patients who have been brought to the emergency room with syncope. The primary idea behind using EGSYS is to estimate and minimize the mortality risk if the syncope is cardiac.

Cardiac syncope has a high mortality rate. The EGSYS helps doctors decide on the best possible course of treatment for patients suffering from cardiac syncope.

Research suggests that using this prediction model in daily practice, clinicians can identify at-risk patients and decide the order of treatment for those patients.

If you are looking for an easy way to estimate the EGSYS score for a patient, the EGSYS calculator is a great tool that you can use for that purpose.

About EGSYS Calculator

The EGSYS calculator uses the standard EGSYS score calculation parameters to calculator the likelihood of cardiac syncope in a patient. This calculator features a set of six questions that the user needs to answer.

Based on the answers that the user provides, the calculator estimates the mortality risk and the possibility of syncope being cardiac or noncardiac.

EGSYS calculator stands out because of how easy it is to use for risk stratification. This tool is designed to help clinicians easily and quickly determine the EGSYS score for their patients.

As soon as a syncope patient is brought into the emergency room, doctors can do the EGSYS score analysis to figure out the possible cause of syncope and decide on the course of treatment in an effective way.

How to Use the EGSYS Calculator?

The EGSYS calculator features a simple design approach that makes it easier to use. The user has to answer the given set of questions as either Yes or No. The calculator keeps track of the inputs provided by the user and once the user hits the calculate button, the calculator predicts the point acquired by the user, the likelihood of cardiac syncope based on the points, and the mortality rate for the patient.

Here are the input parameters for EGSYS:

1. Abnormal EKG and/or heart disease (Yes/No)
2. Palpitations before syncope (Yes/No)
3. Syncope during effort (Yes/No)
4. Syncope in supine position (Yes/No)
5. Autonomic prodromes (Yes/No)
6. Predisposing and/or precipitating factors (Yes/No)

Here are the outputs that you get after the EGSYS calculator:

• Total Points
• Mortality Risks Percentage
• Description of Whether the Syncope is Cardiac or Not

Syncope – Overview, Symptoms, Causes, Diagnosis, and Treatment

Syncope is a commonly used medical term that means fainting or passing out. This condition occurs when the blood flow to the brain temporarily drops to lower than average levels.

This drop in blood flow leads to the loss of muscle control and the patient loses consciousness. Syncope causes the patient to fall on the floor which enables the blood flow to the brain to get back at its normal levels.

Syncope can happen in the case of low blood pressure, a drop in heart rate, or when there is a sudden change in the amount of blood in certain areas of your body.

Syncope is a common medical condition. Although the patient comes back to their senses after a while, you need to go to the hospital after that you have undergone a syncope episode.

Research suggests that syncope affects about 3.5% of women and 3% of men at some point throughout their life. For people older than age 75, the percentage of people suffering from syncope increases to about 6%.

Types of Syncope

Situational Syncope

The syncope that happens because of certain situations that affect the nervous system is referred to as situational syncope. This type of syncope can happen because of the following situations:

• Anxiety
• Fear
• Dehydration
• Pain
• Hunger
• Use of Alcohol
• Drug Abuse
• Hyperventilation
• Coughing Forcefully

Vasovagal Syncope

Vasovagal syncope happens when there is a sudden drop in blood pressure. The drop in blood pressure causes a drop in the flow of blood to the brain which leads to syncope.

Postural Syncope

A quick change in postural position can also sometimes lead to syncope. The sudden change in the posture causes the blood pressure to drop and it causes a syncope episode.

Neurologic Syncope

If a patient is suffering from a neurological condition, they are more likely to experience a neurologic syncope episode. It can happen as a result of a stroke, a seizure, or a Transient Ischemic Attack (TIA).

Postural Orthostatic Tachycardia Syncope

This specific condition occurs when a person stands after sitting or lying down. The sudden shift in the position causes the heart rate to increase, which leads to syncope.

Symptoms of Syncope

There are various warning signs for syncope that can help you catch the problem before it becomes worse.

Below are the most common symptoms of syncope:

• Slurred speech
• Nausea
• Weak pulse
• Dizziness
• Lightheadedness
• Problems in the vision
• Pale skin
• Sudden sweat
• Change in body temperature
• Vertigo
• Increase in the heartbeat
• Headache
• Shakiness
• Numbness

Patients who have undergone a syncope episode before can often feel it coming. Syncope can just be situational, or it can suggest the presence of an underlying serious health condition. This is what makes it important to identify high-risk syncope patients.

Causes of Syncope

Syncope can occur because of external triggers or an underlying health condition. Determining the cause of syncope is the first step towards its effective treatment.

Here are some of the most common causes of syncope:

• Dropped blood pressure
• Dilated blood vessels
• Irregular heartbeat
• Sudden changes in posture
• Extreme fear or anxiety
• Pregnancy
• Dehydration
• Exhaustion
• Underlying health conditions ( e.g., heart health)

 

Syncope Risk Factors

Adults over the age of 75 are at a greater risk for syncope. Although it can happen to men and women of all age groups, older people are more likely to undergo a syncope episode.

People who are suffering from some sort of heart health issue are more likely to experience syncope in their lifetime as compared with people who don’t suffer from cardiac disease. Cardiac syncope is the most dangerous health condition that can be potentially life-threatening.  

Syncope Diagnosis

Syncope can be a one-time event, or it can be recurring. If you have faced multiple episodes of syncope, you should go to a doctor at once for a complete evaluation.

The doctor might refer you to a syncope specialist for the evaluation and to find out the underlying cause for it.

There are various tests out there that help with the syncope diagnosis. The most common one is known as the Tilt Test. The doctors use this test to measure your blood pressure and heart rate in different positions. Doctors use that information to determine whether you are suffering from syncope or not.

Once the doctors diagnose you with syncope, they perform different tests to determine the cause of syncope. These tests include:

• Laboratory Tests – This test is used to check the patient for anemia or metabolic changes that might be causing syncope.
• Exercise Stress Test – This test uses ECG to record the electrical activity of your heart while you are engaged in some kind of physical activity.  
• Electrocardiogram EKG – This test helps with recording the electrical activity of the heart.
• Ambulatory Monitor – This test uses a monitor that the patient needs to wear. It records information about the heart rate and rhythm.
• Echocardiogram – This test uses high-frequency sound waves to generate an image of the heart structures
• Blood Volume Determinization – This test helps determine whether you have the right volume of blood in your body based on factors such as gender, age, weight, and height.
• Autonomic Reflex Testing – This type of testing involves multiple tests that are used to record things such as heart rate, blood pressure, and blood flow. Along with that, the testing also helps keep track of the skin temperature for the patient. All these parameters help pinpoint the cause of syncope in a patient.  

Syncope Treatment

 

The syncope treatment depends on the underlying cause for it. Once the diagnosis phase is done, the doctors analyze the results and start the syncope treatment.

Here are the most common syncope treatment approaches:

Catheter Ablation

Catheter Ablation is a procedure that helps cauterize the heart cells that are causing the heart rate to become abnormal. This causes the heart rate to get back to normal to prevent syncope in the future. 

Pacemakers

A pacemaker is a decision that is inserted under the skin below the collarbone. This device delivers regular electrical pulses using extremely thin wires attached to the heart. This device is quite helpful in preventing syncope.

ICDs

Implantable Cardioverter-Defibrillators (ICDs) are small devices that deliver an electrical pulse to the heart. These devices help patients with extremely irregular heartbeat by making the heartbeat reach the recommended levels. This device is quite useful for preventing heart failure and syncope because it. 

Therapies

The doctors might recommend physical or psychotherapies to deal with the underlying cause of syncope. If you are suffering from vasovagal syncope, then physical therapy to decrease the pooling of blood in the body can be quite helpful for you. Foot exercises are commonly recommended for such patients.

Medication

Patients suffering from vasovagal syncope are often recommended the drug fludrocortisone. This drug helps treat low blood pressure to prevent syncope. When choosing to go for medication for syncope, you should consult a doctor before taking anything.

The above treatment approaches are the ones most commonly used for syncope patients. For best results, an accurate diagnosis of the underlying cause for syncope is critically important.

Syncope Prevention

The best way to prevent syncope is to determine the cause for it and treat that cause. For example, if syncope is because of an external trigger that you know and can identify, it would be best for you to avoid that trigger at all costs.

Patients suffering from severe anxiety need to stay away from high anxiety-inducing situations to avoid syncope. The best treatment approach for these patients would be to see a doctor or a therapist and get their anxiety treated.

In general, avoiding stressful situations is the best way to prevent syncope.

On the other hand, if you can’t identify the cause for syncope then your best course of action would be to see a doctor about this issue. They will analyze your health condition and would assess the severity of the syncope situation.

After that, you need to follow the recommendations of your doctor to minimize the risk of future syncope episodes. 

Conclusion

Although syncope is mostly not life-threatening, it can prove to be a precursor for various health complications. This is why doctors use the EGSYS score to identify high-risk patients so that they can get the help that they need to avoid the mortality risk.

EGSYS calculator is a useful predictive tool for identifying at-risk cardiac syncope patients. This calculator saves the user from the hassle of memorizing the input parameters for EGSYS score calculation and helps do risk stratification in the fastest and the most effective way.

FAQs

1. What is the main cause of syncope?

There is not a single primary or main cause for syncope. It can occur because of many reasons. The most common causes for syncope include low blood pressure, dilated blood vessels, irregular heartbeat, and abrupt changes in posture.

2. Is syncope life threatening?

Syncope is not life-threatening in most cases. But it depends on the underlying cause for syncope. For example, cardiac syncope can lead to death if not treated with utmost urgency. 

3.What are the 4 classifications of syncope?

The four classifications of syncope include:

1. Cardiac Syncope
2. Neurally Mediated Syncope
3. Neurologic Syncope
4. Orthostatic Syncope

4. Does anxiety cause syncope?

Although it is not common, extreme anxiety can cause some people to faint. This health condition is also called vasovagal syncope.

5.Does syncope require hospitalization?

You don’t always need to be hospitalized for syncope. Doctors use the EGSYS approach to identify patients suffering from cardiac syncope and these are the patients who need to get hospitalized for further treatment.

6.What heart conditions cause syncope?

Heart valve disease can often lead to syncope.

7.What are the complications of syncope?

If syncope is recurrent, it greatly affects the quality of life for a person. Other complications include loss of confidence, depression, and physical injuries such as fractures.