Peer Reviewed
Feature Article Neuropathic and neurological pain

Investigating the patient with syncope

Belinda Gray, Mark R Adams
Abstract

Syncope is a common symptom among patients of all ages and ranges from a benign symptom to a warning of impending sudden cardiac death. Physicians should use a framework approach when investigating patients with syncope to ensure life-threatening causes are not missed.

Key Points
  • Syncope is a common presentation to GPs, emergency physicians and cardiologists and may be the presenting symptom in a patient at risk of sudden cardiac death.
  • The most common causes of syncope are cardiac and neurocardiogenic syncope; neurological causes of syncope are rare.
  • Patients with a history of cardiac disease or family history of sudden cardiac death are at particular risk of syncope.
  • An ECG is essential in any patient presenting with syncope.
  • Patients with an unexplained first episode of syncope or recurrent syncope should be referred to a cardiologist for further investigation.
  • Driving restrictions exist following syncopal episodes and need to be enforced by GPs and specialists.
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