Investigation of the efficacy of carotid artery doppler USG in evaluating patients admitted to the emergency department with syncope

Aim: In our study, we aimed to investigate the effectiveness of carotid artery doppler ultrasonography (CADU), which is a non-invasive and radiation-free method, as a tool in the differential diagnosis of patients with syncope of primary unknown etiology.Material and Methods: In this prospective and single-center study, patients aged >= 18 years admitted to the emergency department of a tertiary hospital with syncope were included. CADU examinations were performed by two emergency physicians and two experienced emergency residents. Patients were evaluated and scored on the basis of the San Francisco Syncope Rule (SFSR) system. Statistical significance was set at p<0.05.Results: Among the 140 patients included, those with syncope of unknown origin demonstrated higher rates of previous heart failures, significantly elevated levels of BNP, positively correlated with the SFSR score. Furthermore, 25 of the patients were readmitted within 1 month and these patients had significantly higher rates of bilateral carotid artery stenosis. Therefore, using higher cut-off values for measuring carotid stenosis leads to increased specificity when evaluating readmission. This indicated that CADU can be used for ruling out the need for readmission.Discussion: CADU is an important imaging test in revealing pathological conditions in patients with syncope of unknown etiology and can provide significant results in identifying and excluding patients who could be readmitted within a month. Most studies aim to directly identify the cause of syncope; however, there are limited data to guide clinicians in evaluating and ruling out readmission.