Syncope and Collapse: Medical History

Medical history (history of illness) represents an important component in the diagnosis of syncope or collapse.

Family History

• Has there been a death of a family member younger than 30 years of age?
• Sudden cardiac death in the family?

Social history

• Is there any evidence of psychosocial stress or strain due to your family situation?

Current medical history/systemic history (somatic and psychological complaints) [third-party history, if applicable].

• When did the loss of consciousness* occur? How long were you unconscious?
• Has the unconsciousness occurred more than once? If so, how often? When was the last time?
• In what context did the unconsciousness occur?
  • Body position, pain, shock, activity, food intake, environmental stimuli such as warm room, cold, etc.
  • Urination / defecation, coughing, Valsalva pressure test.
  • Head rotation, tight tie, shaving.
  • Straightening lying out position
  • After a strong physical stress
  • Standing duration?
  • Diarrhea and fever
• Fainting without warning? or
• Were there any announcing symptoms?
  • Epileptic aura such as déjà vu (memory illusion in which a person believes they have previously experienced a present event)?
  • Discomfort/nausea?
  • Sweating?
  • Weakness in the legs?
  • Drowsiness?
• Were there any abnormalities during the attack?
  • Closed eyes
  • Irregular muscle twitching
  • Rhythmic spasmodic voiding
  • Urine output
• Have you noticed any other complaints such as:
  • Dizziness?
  • Heart palpitations?
  • Chest pain* ?
  • Shortness of breath* ?
  • Restlessness?
  • Vomiting?
  • Tongue bite?
  • Bone fractures
• Additional information about the course of events should be obtained via an observer, such as slumping, falling over, duration of unconsciousness, breathing pattern, cyanosis (blue-red discoloration of the skin), flushing (facial redness), muscle tone, seizure equivalents

Vegetative anamnesis incl. nutritional anamnesis.

Self anamnesis incl. medication anamnesis.

• Pre-existing conditions (tumor diseases, cardiovascular diseases, intoxications (poisonings), blood coagulation disorders, injuries; bedriddenness).
• Operations
• Allergies

Medication history

• Acetylcholinesterase inhibitors (AChE inhibitors).
• Angiotensin receptor neprilysin antagonists (ARNI) – dual drug combination: sacubitril/valsartan.
• Antiarrhythmics – amiodarone (QT prolongation).
• Antidepressants – tricyclic antidepressants.
• Antihypertensives – alpha blockers (drugs that act as antagonists at α1- and at α2-adrenoceptors to reduce the effects of epinephrine and norepinephrine), beta-blockers.
• Diuretics
• Dopamine agonists
• Nitrates
• Pentamidine
• Prostacyclin analogues – epoprostenol, iloprost, treprostinil.
• Psychotropic drugs that prolong the QT interval.
• Vasodilators

* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Data without guarantee)