[Syncope: "missed death" or triviality?]

Syncope is a common clinical problem defined as a transient loss of consciousness and postural tone with spontaneous recovery. Etiology is extremely diverse. In a great majority of cases the outcome is favorable; however, if a syncope is of cardiac origin, the risk of subsequent sudden death is relatively high. This fact implies an approach to the evaluation of the possible cause of syncope to minimize the risk of an important misdiagnosed problem. The etiology of syncope is generally found by careful history, clinical examination and an ECG. The strategy to use further investigations is discussed and provides a framework for approaching the final diagnosis prior to initiation of specific treatment.