167 - CHRS SPOTLIGHT: SYNCOPE ACROSS THE AGE SPECTRUM: MANAGEMENT CHALLENGES

Friday, October 28, 2022

3:15 PM – 4:15 PM EDT

Location: Room 214

Target Audience: Clinical cardiologists, Electrophysiologists, Trainee (clinical)

Chair(s)

SR

Satish R. Raj, MD MSCI

Professor of Cardiac Sciences
CHRS
University of Calgary
Calgary, Alberta, Canada

Co-Chair(s)

Roopinder K. Sandhu, MD MPH

Cardiac Electrophysiology
Cedars-Sinai Medical Center/ University of Alberta
Cedars-Sinai Medical Center/ University of Alberta
Los Angeles, California, United States
Laurence D. Sterns, BMSc,MD,FRCPC

Cardiac Electrophysiologist
Royal Jubilee Hospital
Victoria, British Columbia, Canada

Presenter(s)

Tosin Osuntokun (she/her/hers)

Assistant Professor
Women's College Hospital
Women's College Hospital, University of Toronto
Toronto, Ontario, Canada
RS

Robert S. Sheldon, MD PhD FRCP(C) FCAHS FCCS (he/him/his)

Professor Cardiac Sciences
University of Calgary
University of Calgary
Calgary, Alberta, Canada

Planning Committee Member(s)

TH

Tarek Hatoum, MD

Syncope and Autonomics Fellow
Calgary, Alberta, Canada
LK

Louis Kolman, FRCPC

Assistant Clinical Professor
Calgary, Alberta, Canada
LL

Lucy Lei

Undergraduate Researcher
Calgary, Alberta, Canada

Learning Objectives:

At the conclusion of this session, participants will be able to:

diagnose and manage patients with initial orthostatic hypotension;
manage patients with syncope and bifascicular block; and
manage patients with refractory vasovagal syncope.

Syncope is an important clinical problem that will be seen frequently by most cardiologists. The importance of this clinical problem is evidenced by the recent American College of Cardiology Foundation/American Heart Association Guidelines on Syncope that were released in March 2017. In 2020 the CCS published the first ‘Clinical Practice Update on the Assessment and Management of Syncope’. These guidelines highlight the breadth of syncope – in age and in cardiac disease and consequently with varied treatment options.

The accurate diagnosis and management of the underlying cause of the syncope requires the clinician to have exposure to the varied causes and presentations of syncope, many of which vary across different patient ages. Failure to recognize these presentations will often lead to poor, substandard and ineffective care for our patients.

In this workshop, we will use an interactive case-based format to address 3 distinct scenarios of syncope that highlight recent publications that add to our knowledge about treatment options. These 3 scenarios are:

A patient with recurrent vasovagal syncope, with a review of recently published evidenced based treatment options;
A patient with recurrent presyncope (and syncope) immediately on standing, with a focus on the recognition and treatment of initial orthostatic hypotension; and
An older patient with syncope and with bifascicular block on an electrocardiogram, with a discussion about the next steps based on the recently published SPRITELY study

The topic is directly relevant to clinical care in daily practice. Most cardiologists see numerous patients with syncope. We hope that the participants will leave the workshop with an enhanced appreciation of the spectrum of syncope presentations, and a practical approach to its management. These could immediately translate to improved patient care in the clinic.