Syncope History Questions Character: Ask generally Light-headed Off balance Pre-syncope Vertigo Qualitative Ability to move head Ability to walk affecting daily life Ask generally Clinical markers Falls Loss of consciousness Time questions Previous episodes Relieving factors Context and aggravating factors Associated features: Cough -> tussive syncope Passing urine -> micturition syncope Standing for prolonged periods -> postural syncope Emotional stress -> vasovagal Exertional -> aortic stenosis or hypertrophic cardiomyopathy. Have you injured yourself? Nausea Commit Pallor Fatigue Swelling Palpitations SOB Abdominal distension Changes of bowel habits Vision changes Orthopnoea Tongue biting -> seizures Do you wake up feeling normal or drowsy: Normal -> cardiogenic syncope Drowsy -> seizures Sensation of room spinning -> vertigo Medications Prescription medications Non-prescription medications Past medical history Cardiovascular Respiratory Metabolic Neurological Past surgical history Family history Diet Exercise Smoking Alcohol Diet Occupation Travel Differentials CHF Nocturia Fatigue Tachycardia with various arrhythmias Coughing SOB Swellings Distensions Fatigue Hypotension Nausea Fatigue Vision changes Fluid intake Urine output Skin -> dry Aortic stenosis Chest pain SOB Loss of consciousness Dehydration Nausea Fatigue Blood loss Vomit Vision changes Water intake Urine output Skin -> dry or not Atrial fibrillation Palpitations Fatigue Dyspnoea Light headedness IDA Diet Pallor Brittle nails Tachycardia Chest pain ACS Chest pain that is heavy/tight and radiates to the left arm and jaw SORCATES