One of the first steps in approaching the patient with syncope is to distinguish it from other causes of transient loss of consciousness (eg, vertebrobasilar transient ischemic attack, seizure, or metabolic disorder). Any pathological process with pain may cause neurally mediated syncope. Any disease process accompanied by hypovolemia, shock, or autonomic dysfunction can have orthostatic symptoms and result in syncope. Table 3 presents conditions that may mimic syncope but are not due to transient global cerebral hypoperfusion.
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