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recommendationchoosing-wisely· cardiology / emergency medicine / imaging· item cwus-ahaacchrs-001

Avoid CT of the head in patients with syncope and a normal neurological exam and no head trauma. Setting: syncope with a normal neurological examination and no head trauma Why: Routine neuroimaging is not indicated in syncope absent focal neurologic findings or head trauma (2017 ACC/AHA/HRS syncope guideline); yield is negligible and radiation/cost are not. Consider instead: history, examination, orthostatic vitals and a 12-lead ECG; image only for focal neurologic findings or head injury Source: AHA/ACC/HRS (guideline-derived, US, 2017).