USMLE Adviser
Syncope: Step-by-Step Approach (Flowchart)
This is the complete syncope flowchart from the USMLE Adviser e-book, shared free. It turns the presentation into a short series of yes/no questions, the way Step 2 CK and Step 3 vignettes are reasoned through. The same logic is written out as text below the image.
The flowchart, step by step
- During exertion or without warning?
- Yes → Palpitations / abnormal ECG?
- Yes → Arrhythmia
- No → Systolic murmur?
- Yes → Aortic stenosis
- No → Consider HCM / other cardiac cause
- No → After standing?
- Yes → Orthostatic hypotension
- No → Triggered by pain / fear / emotion?
- Yes → Vasovagal syncope
- No → During urination / cough / defecation?
- Yes → Situational syncope
- No → Prolonged post-event confusion / tongue biting?
- Yes → Seizure
- No → Other causes
- Yes → Palpitations / abnormal ECG?
Diagnoses covered
Arrhythmia, Aortic stenosis, Consider HCM / other cardiac cause, Orthostatic hypotension, Vasovagal syncope, Situational syncope, Seizure, Other causes.
FAQs
What is the first question in the syncope flowchart?
The flowchart starts with During exertion or without warning? Each answer leads to the next yes/no decision until you reach a likely diagnosis.
Which diagnoses does this flowchart cover?
Arrhythmia, Aortic stenosis, Consider HCM / other cardiac cause, Orthostatic hypotension, Vasovagal syncope, Situational syncope, Seizure, Other causes.
Is this the full flowchart from the e-book?
Yes. This is page 4 of the USMLE Adviser e-book, shared free. The full e-book has 232 flowcharts.
Related flowcharts
Want all 232 flowcharts?
The USMLE Adviser e-book has 232 one-page clinical flowcharts across 19 specialties for Step 2 CK, Step 3 and the Match. Instant digital download.
From Clinical Algorithms: Volumes 1 & 2 by Dr. Adnan Memon, MD (page 4). Reviewed by the USMLE Adviser Team. For exam preparation only, not medical advice.