Canadian Cardiovascular Society Clinical Practice Update on the Assessment and Management of Syncope.

Syncope is a symptom that occurs in multiple settings and has a variety of underlying causes, ranging from benign to life threatening. Determining the underlying diagnosis and prognosis can be challenging and often results in an unstructured approach to evaluation, which is ineffective and costly. In this first ever document, the Canadian Cardiovascular Society (CCS) provides a clinical practice update on the assessment and management of syncope. It highlights similarities and differences between the 2017 American College of Cardiology/American Heart Association/Heart Rhythm Society and the 2018 European Society of Cardiology guidelines, draws on new data following a thorough review of medical literature, and takes the best available evidence and clinical experience to provide clinical practice tips. Where appropriate, a focus on a Canadian perspective is emphasized in order to illuminate larger international issues. This document represents the consensus of a Canadian panel comprised of multidisciplinary experts on this topic with a mandate to formulate disease-specific advice. The primary writing panel wrote the document, followed by peer review from the secondary writing panel. The CCS Guidelines Committee reviewed and approved the statement. The practice tips represent the consensus opinion of the primary writing panel authors, endorsed by the CCS. The CCS clinical practice update on the assessment and management of syncope focuses on epidemiology, the initial evaluation including risk stratification and disposition from the emergency department, initial diagnostic work-up, management of vasovagal syncope and orthostatic hypotension, and syncope and driving.

Canadian Cardiovascular Society position statement on radiation exposure from cardiac imaging and interventional procedures.

Exposure to ionizing radiation is a consequence of many diagnostic and interventional cardiac procedures. Radiation exposure can result in detrimental health effects because of deterministic (eg, skin reaction) and stochastic effects (eg, cancer). However, with the levels experienced during cardiac procedures these risks can be difficult to quantify. Healthcare providers and patients might not fully appreciate radiation-related risks. Though in many cases radiation exposure cannot be avoided, a practice of minimizing exposures to levels "as low as reasonably achievable" (ALARA principle) without compromising the utility of the procedure is encouraged. The purpose of this document is to inform health care providers on the key concepts related to radiation risk from common cardiac procedures and provide specific recommendations on ensuring quality of care.