The Cardiovascular
ToolsCalculators

EGSYS Score for Syncope

Probability that syncope is of cardiac origin.

EGSYS Score for Syncope
Abnormal ECG and/or heart disease
Palpitations before syncope
Syncope during effort/exertion
Syncope while supine
Autonomic prodromes (nausea/vomiting)
Precipitating/predisposing factors (warm place, prolonged standing, fear/pain/emotion)
Result0 points

Score <3 makes a cardiac cause less likely (2-year mortality about 2%).

Cardiac syncope likely
No

When to use

  • Distinguishing likely cardiac syncope from other causes in the ED.

Formula

Abnormal ECG/heart disease +3; palpitations before syncope +4; syncope on effort +3; syncope while supine +2; autonomic prodromes -1; precipitating/predisposing factors -1. Range -2 to 12.

Pearls and pitfalls

  • Score >=3 has high sensitivity for cardiac syncope but modest specificity.
  • A cardiac cause warrants admission and cardiac work-up.

References

  1. Del Rosso A, et al. Heart. 2008;94(12):1620-6.