Onset of syncope denotes a poor prognosis in patients with CAD, myocarditis, cardiomyopathy, and known ventricular arrhythmias. Intracardiac tumors or ball-valve thrombi can intermittently obstruct blood flow within the heart, producing presyncope or syncope. Postural hypotension and vasovagal syncope are the major benign causes of syncope. Syncope must be differentiated from epileptic seizures, although seizures due to brain hypoxia can occur in a syncopal episode. Endocarditis should be considered in any patient with an unexplained fever and a heart murmur.
Central cyanosis makes a congenital cardiac disorder highly likely.
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