Lower risk	Higher risk
Episode history
After prolonged standing During or after a meal Caused by head rotation or pressure on carotid sinus Caused by positional change from supine or sitting to standing With a prodrome typical for reflex syncope With a trigger such as cough, defecation, or micturition In a younger patient	Associated with chest pain, shortness of breath, abdominal pain, headache Associated with sudden-onset palpitations Family history of sudden cardiac death at young age Lack of prodrome In a male patient Occurs during exertion Occurs while sitting or supine In an older patient
Medical history
Absence of known heart disease History of recurrent episodes with similar low-risk features, particularly in a patient younger than 40 years	History of heart disease
Physical examination
Normal physical examination findings	Persistent bradycardia < 40 beats per minute in the absence of physical training Suggestion of gastrointestinal bleeding Previously undiagnosed systolic murmur Unexplained systolic blood pressure < 90 mm Hg