Evaluation and treatment

Anamnesis

• duration
• circonstances d'apparition
• sweating
• room temperature
• prodromes

Complete status

ECG (12 leads)

• conduction disorders (or specific patterns for arrhythmogenic disease, delta or epsilon wave or Brugada syndrome)
• arrhythmias
• QT interval prolongation
• sinus arrest

Laboratory examination

• Hb
• glycemia
• électrolytes
• CK
• troponines
• creatinine

Blood pressure measurement

• lying and standing position

If a final diagnosis is found adapt the treatment, if not, decided about hospitalization of the patient based on the following scores: OESIL et EGSYS.

Low risk and first episode

• Send the patient at home.

Low risk and recidive

• carotid sinus massage
• orthostatism test
• tilt test
• Holter monitoring
• stress test (if syncope on effort)
• long lasting arrhythmia monitoring (Reveal)

High risk (hospitalized the patient and initiate the following examinations)

• ECG monitoring
• echocardiography
• tilt test
• Holter monitoring
• electrophysiological testing
• stress test