Syncope: a clinically guided diagnostic algorithm.
The initial evaluation of a patient with syncope should include a thorough clinical history, physical examination and 12 lead electrocardiogram (ECG). The history is the best diagnostic tool. Clinical findings guide further testing. Patients with syncope and heart disease require echocardiography, Holter monitoring or exercise testing. The tilt test and carotid sinus massage are useful to reproduce reflex syncope. An insertable subcutaneous loop recorder can provide prolonged ECG monitoring.
Kaufmann
Horacio
H
Mount Sinai School of Medicine, Box 1052, New York, NY 10029, USA. horacio.kaufmann@mssm.edu.
Wieling
Wouter
W
D000465:Algorithms; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation; D006801:Humans; D019736:Prostheses and Implants; D013575:Syncope / Q000175:diagnosis* / Q000209:etiology