[Initial diagnostic strategy in the case of transient losses of consciousness: the importance of the medical history].
It is estimated that almost half of the people experience a transient loss of consciousness at some time during their life. In young patients (< 35 years) the cause is mostly a reflex syncope. In older patients the common causes are orthostatic and postprandial hypotension, sinus caroticus syndrome, cardiac arrhythmias and valvular disorders. The medical history can identify a probable cause of the transient loss of consciousness in almost all young patients (< 35 years) and in the majority of older patients. A physical examination and an ECG should be performed in all patients who have experienced a transient loss of consciousness, other than those with classical vasovagal syncope, in order to exclude orthostatic hypotension and dangerous cardiac causes.
Wieling
W
W
Academisch Medisch Centrum/Universiteit van Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam. w.wieling@amc.uva.nl
Ganzeboom
K S
KS
Krediet
C T P
CT
Grundmeijer
H G L M
HG
Wilde
A A M
AA
van Dijk
J G
JG
D000328:Adult; D000367:Age Factors; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010808:Physical Examination; D013575:Syncope / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology