Field of medicine: Cardiology and neurology.

Format: Hardcover book.

Audience: Physicians who evaluate and treat patients with syncope, such as internists, family practitioners, pediatricians, geriatricians, and cardiologists.

Purpose: To serve as a comprehensive and usable reference on syncope.

Content: In a series of critical and focused reviews of the diverse disorders causing syncope, this text provides important insights into the evaluation and management of this common symptom. The initial chapters deal with the scope and impact of the problem and provide practical guidelines for the clinical assessment of patients with syncope. Subsequent chapters offer a well-organized discussion of the evaluation, pathogenesis, and treatment of specific neurologic, cardiovascular, and psychiatric disorders associated with this symptom. The concluding chapters address special features of syncope in elderly and pediatric populations and summarize major medicolegal issues relevant to this symptom.

Highlights: Chapters 3, 5, and 8 provide particularly thorough discussions of three major causes of syncope. Chapter 3 summarizes typical and atypical presentations of neurocardiogenic syncope and includes a detailed description of head-upright tilt-Table testing. Recent clinical investigations of therapies for neurocardiogenic syncope are discussed in the context of postulated pathophysiologic mechanisms. Chapter 5 discusses sinus node dysfunction, atrioventricular conduction disturbances, and congenital and acquired conduction system disease. Indications for pacing and electrophysiologic study in the setting of bradyarrhythmias are given. Chapter 8 summarizes neurologic syndromes associated with syncope, focusing on distinguishing aspects of clinical presentation. Illustrations, tables, and case studies are effectively used throughout the text for clarification and emphasis.

Limitations: Although the inclusion of sample electrophysiologic tracings is helpful, their abbreviated labels may impede interpretation by nonelectrophysiologists.

Related reading: This text may represent the most thorough treatment of syncope to date. Although information on this important symptom is found in periodicals and major cardiology texts, such as Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 5th edition (WB Saunders, 1997), no other publication presents as detailed and comprehensive a review of this subject.

Reviewer: Marcie G. Berger, MD, Medical College of Wisconsin, Milwaukee, Wisconsin.