What should you know about syncope work up?

A clinician asks what happened before, during and after the episode. Standing, heat, pain, missed meals, medicines, palpitations, injury and speed of recovery can distinguish fainting from other causes of lost awareness.

The examination may include blood pressure and pulse, including position changes, plus heart and nervous-system checks and an electrocardiogram. Further tests depend on the findings. Anaemia, Atrial Fibrillation, Dehydration and Hypoglycaemia can be considered, but fainting alone does not diagnose any of them.

Arrange assessment after unexplained fainting, particularly after a repeat episode or injury. Record symptoms, recent illness, food and fluid intake, medicines, alcohol use and family history of sudden heart problems. Rise slowly, avoid hazardous activities if another episode could endanger you, and do not stop prescribed medicine without advice.

Call emergency services if fainting occurs during exercise or while lying down, or with chest pain, severe breathlessness, an irregular heartbeat, serious injury, prolonged confusion, seizure-like movements, one-sided weakness or trouble speaking. Seek prompt review in pregnancy, known heart disease or abnormal recovery. Check breathing and keep an unconscious person safely positioned; do not give food or drink until fully awake.

Ask what the episode resembles, whether you need an electrocardiogram or blood tests, which medicines or conditions may contribute, whether activity or driving should change, and which symptoms require emergency care.