Syncope as a symptom. A practical approach to etiologic diagnosis.

Etiologic diagnosis of syncope is best approached within the framework of three categories: cardiovascular, noncardiovascular, and unexplained. A meticulous history and physical examination plus screening laboratory studies will pinpoint a cause in nearly half of cases. In patients who have recurrent syncope, a history suggestive of dysrhythmia, or structural heart disease, further testing may include a variety of procedures such as 24-hour electrocardiographic monitoring, two-dimensional echocardiography, exercise stress testing, and electrophysiologic testing.