Initial diagnostic strategy in the case of transient losses of consciousness: the importance of the medical history
Wieling, W.; Ganzeboom, K.S.; Krediet, C.T.P.; Grundmeijer, H.G.L.M.; Wilde, A.A.M.; van Dijk, J.G.
Nederlands Tijdschrift Voor Geneeskunde 147(18): 849-854
2003
ISSN/ISBN: 0028-2162 PMID: 12756875 Document Number: 555128
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.