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: