38. Syncope.
Syncope is a common clinical problem caused by transient cerebral hypoperfusion and encompasses reflex, orthostatic, and cardiac mechanisms. Accurate diagnosis relies on careful history taking and physical examination, as well as targeted testing guided by risk stratification. Management of syncope is determined on the basis of the underlying mechanism and focuses on reducing recurrence and injury risk. In older patients, syncope may manifest as unexplained falls. Early identification of high-risk features is critical to prevent adverse cardiovascular outcomes.
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