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abstractA patient presented several episodes of fainting which the doctor initially interpreted as emotional presyncope. In actual fact the correct diagnosis was syncope, related to a cardiovascular disorder. The difference between presyncope and syncope lies in the strength of the symptomatology, but they may have the same causes. The patient’s history and objective examination can help to identify the cause of syncope. For example, reflex syncope has quite stereotyped features. In an elderly person being treated with numerous cardiovascular drugs, the appearance of symptoms of presyncope when he gets out of bed leads one immediately to think of orthostatic hypotension. However, mistaken diagnoses can occur, as this case confirms. When gathering the patient’s history, one should assess previous episodes, warning symptoms, loss of consciousness, the patient’s memory of the episode, the factors that triggered the event, any biting of the tone, loss of faeces or urine, and the pharmacological treatment that the patient is currently undergoing.
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