Since Prandoni et al published their findings in the NEJM's October 2016 issue (reporting a 17.3% incidence of pulmonary embolism among patients admitted with first time syncope), there has been controversy swirling in the EM community.  Questions have been raised regarding the impact of this study, its generalizability, and its implications for clinical practice.  At this month’s journal club, we broke down the findings in the Prandoni study as well as looked at two other studies (Castelli et al and Altinsoy et al) that examined the clinical characteristics of patients with PE who presented with syncope.