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Syncope high-risk disposition — ABEM Board MCQ

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ModerateCardiovascular emergenciesSyncope high-risk dispositionABEM Board

A 68-year-old man arrives after syncope while walking upstairs. Triage acuity is ESI 2; BP 104/62 mm Hg, HR 48/min. He has exertional dyspnea and a harsh systolic murmur radiating to the carotids. ECG shows left ventricular hypertrophy with strain. Which of the following is the most appropriate disposition?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Admit for monitored evaluation and echocardiography

Exertional syncope with bradycardia and aortic stenosis findings is high risk and warrants monitored inpatient evaluation.

Reference: ACEP syncope risk guidance; ACC/AHA valvular heart disease guidance