Approach to the Pt with Syncope - Flowchart
Approach to the Pt with Syncope - Flowchart
«Flowchart»

Syncope

Syncope

Syncope

Syncope

Reflex syncope

Reflex syncope

Reflex syncope

End

End

End

Normal history and physical examination

Normal history and physical examination

Normal history and physical examination

History, physical examination, ECG suggest cardiac disease

History, physical examination, ECG suggest cardiac disease

History, physical examination, ECG suggest cardiac disease

Examination reveals orthostatic hypotension

Examination reveals orthostatic hypotension

Examination reveals orthostatic hypotension

Review medication

Review medication

Review medication

Echocardiogram, 24-h Holter monitor, stress test, other cardiac testing as indicated

Echocardiogram, 24-h Holter monitor, stress test, other cardiac testing as indicated

Echocardiogram, 24-h Holter monitor, stress test, other cardiac testing as indicated

Tilt testing if severe or recurrent

Tilt testing if severe or recurrent

Tilt testing if severe or recurrent

Consider postganglionic autonomic insufficiency

Consider postganglionic autonomic insufficiency

Consider postganglionic autonomic insufficiency

Normal neurologic examination

Normal neurologic examination

Normal neurologic examination

Abnormal neurologic examination

Abnormal neurologic examination

Abnormal neurologic examination

Peripheral neuropathy (consider diabetic, nutritional, amyloid, etc.)

Peripheral neuropathy (consider diabetic, nutritional, amyloid, etc.)

Peripheral neuropathy

Central nervous system findings
Consider multiple system atrophy

Central nervous system findings
Consider multiple system atrophy


Central nervous system findings