Syncope: what to consider when the history and physical exam are not suggestive of an etiology

ECG Weekly Workout with Dr. Amal Mattu


A 20-year-old male presents to the ED after a syncopal episode while playing soccer. He reports feeling dizzy before collapsing. He was seen in the ED a few days ago after a similar event, but no ECG was done because it was thought that he had a seizure. He is asymptomatic on arrival with normal vital signs. The following ECG is obtained:

Before watching this week’s video, ask yourself these questions:

  1. What is your ECG interpretation?
  2. What is your differential when interpreting the ECG of patients with syncope when the history and physical exam are non-diagnostic?
  3. What is the most likely cause of this patient’s symptoms?