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San Francisco Syncope Rule

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San Francisco Syncope Rule, CHESS Criteria

  • See Also
  1. Syncope
  2. Canadian Syncope Risk Score
  • Indications
  1. Syncope Evaluation
    1. Evaluate short-term risk of serious outcome
    2. May reduce Syncope hospitalization rate
  • Criteria (Mnemonic
  • CHESS)
  1. Congestive Heart Failure history
  2. Hematocrit <30%
  3. Electrocardiogram abnormal
  4. Shortness of Breath
  5. Systolic Blood Pressure <90 mmHg at triage
  • Interpretation
  1. Positive: One of criteria above
  • Efficacy
  • Risk for short-term serious Syncope outcome (30 day mortality)
  1. Test Sensitivity: 96% (misses 4% of cases)
  2. Test Specificity: 62%
  • References
  1. Quinn (2004) Ann Emerg Med 43:224-32 [PubMed]