April 2013 Newsletter Distinguishing Cardiac Syncope from Vasovagal Syncope in a Referral Population Justin Tretter, M.D., is working with Rae-Ellen Kavey, M.D., M.P.H. in the Division of Pediatric Cardiology on a project entitled "Distinguishing Cardiac Syncope from Vasovagal Syncope in a Referral Population." This project aims to identify characteristics that distinguish cardiac from vasovagal syncope. Dr. Tretter’s retrospective review showed dramatic differences in presentation, from which a screening rule was created using historic features, physical examination findings and ECG to help identify patients requiring cardiology referral. When applied to each cohort, the screening rule would have identified all patients with cardiac etiology, and decreased referral for cardiology evaluation among those with vasovagal syncope by 60%. A manuscript describing the findings of this study and the resulting screening rule is currently under review.