Abstract
Patients with life-threatening conditions that present with syncope can be recognized promptly and appropriately with history, physical electrocardiogram (EKG), and echocardiography. Once diseases are recognized, exercise testing may be part of disease characterization and management. Exercise testing has a critical role in patients with high-risk histories of syncope, to evaluate for catecholaminergic polymorphic ventricular tachycardia (CPVT) and other unusual arrhythmia syndromes. Most patients with low severity, typical syncope will not benefit from exercise testing (or any substantial testing). For patients with more problematic symptoms, exercise testing represents a relatively low barrier test that can identify multiple contributors to symptoms. This includes deconditioning, abnormal or potentially abnormal blood pressure responses, and incidental or potentially important arrhythmias. The differences between normal and abnormal exercise responses in those with potential orthostatic syndrome overlap with normal physiology. Testing always needs to be interpreted in context.
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Alexander, M.E. (2019). Syncope, Orthostatic Intolerance, and Exertional Symptoms. In: Rhodes, J., Alexander, M., Opotowsky, A. (eds) Exercise Physiology for the Pediatric and Congenital Cardiologist. Springer, Cham. https://doi.org/10.1007/978-3-030-16818-6_29
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DOI: https://doi.org/10.1007/978-3-030-16818-6_29
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