Syncope Emergency Workup

Syncope is a brief loss of consciousness caused by inadequate global cerebral perfusion, followed by rapid, spontaneous, and complete recovery. It is a symptom, not a final diagnosis. The emergency question is whether the episode reflects a benign reflex or orthostatic mechanism—or an arrhythmia, structural heart problem, bleeding event, pulmonary embolism, or another serious condition. The first assessment has three essential components: a detailed history, a physical examination that includes orthostatic vital signs when safe, and a 12-lead ECG. These findings establish the likely mechanism and determine whether targeted testing, monitored observation, hospital treatment, or outpatient follow-up is appropriate. A risk score supports that judgement; it does not replace it.