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Clinical diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The initial consultation consists of a careful history and examination and an ECG.

The diagnosis may become clear at this stage, for example:

  • vasovagal syncope:
    • occurs after pain or unpleasant site or smell
    • after prolonged standing

  • orthostatic syncope
    • occurs when the patient stands up

  • heart block:
    • past history of ischaemic or congenital heart disease

  • situational syncope:
    • events occur after micturition, defecation, coughing or swallowing

  • drug-induced syncope:
    • the patient is taking drugs which prolong the QT interval

  • neurally mediated syncope with neuralgia:
    • events associated with throat or facial pain

  • syncope associated with other significant cardiovascular disease

  • syncope with a family history of sudden cardiac death:
    • Long QT syndrome
    • Brugada syndrome

  • subclavian steal:
    • syncope is associated with work with the arms

  • frequent unexplained syncope with somatic symptoms:
    • psychiatric disease

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