Clinical features of young patients presenting with syncope have been underreported.
Methods: Retrospective review using U.S. Military Health System's Theater Medical Data Store and Joint Medical Workstation identified patients evaluated for syncope from January 2005 to October 2007 while deployed to a combat zone.
Results: We identified 848 patients with syncope. The majority (80.8%) were under the age of 40. The diagnostic yield of the ECG was 2.0%. In those <40 years, there were no head CTs or transthoracic echocardiograms that identified a cause of syncope. There was no difference in evacuation out of theater between those <40 years and those >40 years (10.8% vs. 8.6%, p = 0.08). Patients with a prior episode of syncope were more likely to undergo medical evacuation outside of the combat zone (16.0% vs. 7.7%, p < 0.01).
Discussion: Evacuation of those <40 years to facilities with advanced imaging did not add diagnostic information.