Research Article

Diagnostic Yield of Echocardiography in Syncope Patients with Normal ECG

Table 2

Echocardiographic findings in patients with abnormal TTE in both normal and abnormal ECG groups.

TTE findingsDischarge diagnosisEcho useful in diagnosis of syncope?

Normal ECG with abnormal TTE ()Moderate-severe aortic stenosis with mild aortic insufficiencyOrthostatic hypotensionNo
Severe aortic stenosis Multifactorial nonspecific causeNo
Severe aortic stenosis. Normal LV function with EF 55–60%. Mild concentric LVH.Undetermined causeNo
Right atrial enlargement. Right ventricular hypertrophy. Severe tricuspid regurgitation. Mild mitral regurgitation.Orthostatic hypotensionNo
LVEF 35–40% with grade I diastolic dysfunctionUnknown No
Estimated left ventricular ejection fraction of 40%.
Mild mitral regurgitation.
Unknown No
LVEF 40% diffuse hypokinesisUnknownNo
LV cardiomyopathy, LVEF 35–40%UnknownNo
Moderate global hypokinesis of the left ventricle with ejection fraction 35%. Tricuspid regurgitationUnknownNo
Moderate LV dysfunction with EF 40% and diffuse hypokinesis. Aortic root calcification. Vasovagal response No
Mild dilated LV with reduced systolic function. EF 35%. Moderate global hypokinesis. Vasovagal responseNo

Abnormal ECG with abnormal TTE () Mild mitral valve prolapse. Concentric LVH. Septal hypokinesis. Moderate left atrial enlargement. Severe pulmonary hypertension. Severe pulmonary hypertensionYes
Severe MR, severe TROrthostatic hypotensionNo
Patient in atrial fibrillation rhythm.
Moderate hypokinesis of the LVEF 35–40%.
LVEF 40%Atrial flutter with RVRNo
Mildly dilated left ventricle with severely reduced systolic function and LVEF of 25–30%. Moderate concentric left ventricular hypertrophy.UnknownNo
LVEF of 40–45%. Akinesis of the anterior septum and inferior septum. Trace MR and TR.Vasovagal responseNo
LV enlargement. Generalized hypokinesis. EF ~25%.UnknownNo
LVEF 30%. Diffuse hypokinesisAcute HF exacerbation with respiratory failureNo
Moderate AI and TR. LVEF 30%, LVHCarotid hypersensitivityNo
LV enlargement with generalized hypokinesis and EF 25–30%UnknownNo
Moderate LA enlargement. Moderate-severe MR.UnknownNo
Dilated LV with EF ~25%UnknownNo
Marked anteroapical hypokinesis with LVEF ~30%. Mild-Moderate AI.UnknownNo
LVH. Normal EF. Large significant pericardial effusion.Large pericardial effusionYes
LVEF 30%. LVH.Vasovagal responseNo
LVEF 30% with diffuse hypokinesis. Vasovagal responseNo
LV enlargement with generalized hypokinesis. EF 25–30%Ventricular fibrillation status after ICD shockNo
Generalized hypokinesis. Paradoxical septal motion. LVEF 25%, MR and TRParadoxical septal motionYes
Left ventricular hypertrophy.
Paradoxical motion of interventricular septum with preserved LV systolic function. Mild to moderate tricuspid insufficiency
Sinus bradycardia secondary to medication overdoseNo
LVEF severely reduced and estimated at 25%. Severe global hypokinesis of the left ventricle. The entire inferior wall is akinetic. Impaired left ventricular relaxation. Severe mitral regurgitation. UnknownNo
Severe aortic stenosis. LVEF normal. Severe aortic stenosisYes
Asymmetrical septal hypertrophy of the left ventricle. Associated moderate left ventricular outflow tract gradient of 30 mmHg. Associated “pseudo-SAM” with no true systolic anterior motion of the mitral valve noted. Grade II left ventricular diastolic dysfunction. HOCMYes
Severe left ventricular dysfunction.
Moderately severe to severe mitral regurgitation.
Severe conduction diseaseNo
LVEF of 30%. Mild MR. Mild to moderate TR. Anteroapical hypokinesis and septal akinesis.Acute HF exacerbation with respiratory insufficiencyNo
Dilated LV with EF 35%. Moderate global hypokinesisVasovagal responseNo
LVEF 35%. Inferior hypokinesisUnknownNo
LVEF of 35–45%. Findings compatible with pericardial effusion with right atrial cyclic compression. Significant pericardial effusionYes

LVEF, left ventricular ejection fraction. AI, aortic insufficiency. MR, mitral regurgitation. TR, tricuspid regurgitation. LVH, left ventricular hypertrophy.
Previously documented AS on prior echo and hospital records.