A retrospective analysis of the cost-effective workup of syncope in children1

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Syncope in children can result from a wide variety of causes. Consequently, an evaluation that fails to approach this problem in a goal-directed fashion often proves to be extremely expensive, time-consuming, and frustrating to all concerned. In today's medical and economic climate, it is crucial to implement a cost-effective approach to the workup of children with syncope. The authors evaluated 73 children with syncope, using a total of 443 diagnostic tests or consultations at a total cost of $77,419. In a large proportion of patients, the cause of the syncope could not be established. The initial clinical examination with special emphasis on historical data, if it suggests a probable cause, should direct the physician in further diagnostic workup. This examination should include a complete physical and ECG. If warranted, a goal-directed, cost-effective workup can then ensue.



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