[Diagnostic clarifications and follow-up of 105 patients with syncope]

105 patients with syncope (56 males and 49 females aged 15-87 years) were followed up for 15 +/- 8 months after their first visit in an outpatient clinic. Diagnosis after initial evaluation was syncope of unknown origin (n = 24), vasodepressor syncope (n = 18), orthostatic syncope (n = 18), syncope of cardiac origin (n = 16), seizure disorder (n = 13), syncope occurring during hyperventilation (n = 6), micturition syncope (n = 6), cough syncope (n = 2), and vertebrobasilar transient ischemic attack (n = 2). In 55% of patients the diagnosis was based on the patient's history alone and only in 23 patients was additional laboratory workup of diagnostic importance. During follow-up 4 patients died, but only in one was death related to the syncope (recurrent ventricular tachycardial). In 1 patient the initial diagnosis after follow-up had to be changed (from syncope of unknown origin to cardiogenic syncope) due to sick sinus syndrome. In patients with syncope the history should be carefully evaluated, since it is diagnostic in more than half of the cases. An additional diagnosis workup including resting and 24-hour ECG, as well as EEG examinations, should be ordered not as screening but only in selected patients.