<HTML><BODY style="word-wrap: break-word; -khtml-nbsp-mode: space; -khtml-line-break: after-white-space; ">Dr. Ariel Szyszko from Argentina asks<DIV><BR class="khtml-block-placeholder"></DIV><DIV>- <SPAN lang="EN-US" style=""><FONT class="Apple-style-span" face="Arial" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">In syncope with clear anamnesis of vasovagal cause, is it essential to perform a TILT TEST?</SPAN></FONT></SPAN><FONT class="Apple-style-span" face="Arial" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;"></SPAN></FONT><SPAN class="Apple-style-span" style="border-collapse: collapse;"></SPAN></DIV><DIV><FONT class="Apple-style-span" face="Arial" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;"><BR class="khtml-block-placeholder"></SPAN></FONT></DIV><DIV><SPAN class="Apple-style-span" style="border-collapse: collapse;"><FONT class="Apple-style-span" face="Arial" size="4"><SPAN class="Apple-style-span" style="font-size: 13.3333px;">Dr. Stephen Hammill from U.S.A. answers</SPAN></FONT></SPAN></DIV><DIV><FONT class="Apple-style-span" face="Arial" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;"><BR class="khtml-block-placeholder"></SPAN></FONT></DIV><DIV><SPAN class="Apple-style-span" style="border-collapse: collapse;"><FONT class="Apple-style-span" face="Arial" size="4"><SPAN class="Apple-style-span" style="font-size: 13.3333px;">- <SPAN lang="ES-MX" style="">It is not essential to perform a tilt test on a patient with a history</SPAN><TABLE border="1" cellspacing="0" cellpadding="0" width="1584" style="width: 1584pt; border-top-style: none; border-right-style: none; border-bottom-style: none; border-left-style: none; border-width: initial; border-color: initial; "><TBODY><TR><TD width="109" valign="top" style="width:109.25pt;border:solid windowtext .5pt; padding:0cm 5.4pt 0cm 5.4pt"><DIV class="MsoNormal"><SPAN lang="ES-MX" style=""><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">that is classic for vasovagal syncope assuming the remaining aspects of</SPAN></FONT><FONT class="Apple-style-span" face="Helvetica"><SPAN class="Apple-style-span" style="border-collapse: collapse;"><O:P></O:P></SPAN></FONT></SPAN></DIV><DIV class="MsoNormal"><SPAN lang="ES-MX" style=""><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">their history ore normal (such as no family history of sudden death) and</SPAN></FONT><FONT class="Apple-style-span" face="Helvetica"><SPAN class="Apple-style-span" style="border-collapse: collapse;"><O:P></O:P></SPAN></FONT></SPAN></DIV><DIV class="MsoNormal"><SPAN lang="ES-MX" style=""><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">their physical examination and ECG are normal.</SPAN></FONT><SPAN style="mso-spacerun: yes"><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;"> </SPAN></FONT></SPAN><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">I may elect to obtain an</SPAN></FONT><FONT class="Apple-style-span" face="Helvetica"><SPAN class="Apple-style-span" style="border-collapse: collapse;"><O:P></O:P></SPAN></FONT></SPAN></DIV><DIV class="MsoNormal"><SPAN lang="ES-MX" style=""><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">echocardiogram if any concerns are raised by the history, examination or</SPAN></FONT><FONT class="Apple-style-span" face="Helvetica"><SPAN class="Apple-style-span" style="border-collapse: collapse;"><O:P></O:P></SPAN></FONT></SPAN></DIV><DIV class="MsoNormal"><SPAN lang="ES-MX" style=""><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">basic testing.</SPAN></FONT><FONT class="Apple-style-span" face="Helvetica"><SPAN class="Apple-style-span" style="border-collapse: collapse;"><O:P></O:P></SPAN></FONT></SPAN></DIV><DIV class="MsoNormal"><SPAN lang="ES-MX" style=""><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;"> </SPAN></FONT><FONT class="Apple-style-span" face="Helvetica"><SPAN class="Apple-style-span" style="border-collapse: collapse;"><O:P></O:P></SPAN></FONT></SPAN></DIV><DIV class="MsoNormal"><SPAN lang="ES-MX" style=""><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">Stephen C. Hammill, MD</SPAN></FONT><FONT class="Apple-style-span" face="Helvetica"><SPAN class="Apple-style-span" style="border-collapse: collapse;"><O:P></O:P></SPAN></FONT></SPAN></DIV><DIV class="MsoNormal"><SPAN lang="ES-MX" style=""><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">Professor of Medicine, Mayo Clinic College of Medicine</SPAN></FONT><FONT class="Apple-style-span" face="Helvetica"><SPAN class="Apple-style-span" style="border-collapse: collapse;"><O:P></O:P></SPAN></FONT></SPAN></DIV><DIV class="MsoNormal"><SPAN lang="ES-MX" style=""><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">Director, Electrocardiography Laboratory</SPAN></FONT><FONT class="Apple-style-span" face="Helvetica"><SPAN class="Apple-style-span" style="border-collapse: collapse;"><O:P></O:P></SPAN></FONT></SPAN></DIV><DIV class="MsoNormal"><SPAN lang="ES-MX" style=""><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;"><A href="mailto:hammill.stephen@mayo.edu">hammill.stephen@mayo.edu</A></SPAN></FONT></SPAN><SPAN lang="EN-US" style=""><FONT class="Apple-style-span" face="Helvetica"><SPAN class="Apple-style-span" style="border-collapse: collapse;"><O:P></O:P></SPAN></FONT></SPAN></DIV></TD></TR></TBODY></TABLE><FONT class="Apple-style-span" face="Helvetica"><BR></FONT></SPAN></FONT></SPAN><DIV> <SPAN class="Apple-style-span" style="border-collapse: separate; border-spacing: 0px 0px; color: rgb(0, 0, 0); font-family: Helvetica; font-size: 12px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; text-align: auto; -khtml-text-decorations-in-effect: none; text-indent: 0px; -apple-text-size-adjust: auto; text-transform: none; orphans: 2; white-space: normal; widows: 2; word-spacing: 0px; "><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">--</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">Dr.<SPAN class="Apple-converted-space"> </SPAN>Sergio<SPAN class="Apple-converted-space"> </SPAN>Dubner</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">President<SPAN class="Apple-converted-space"> </SPAN>of<SPAN class="Apple-converted-space"> </SPAN>Scientific<SPAN class="Apple-converted-space"> </SPAN>Committee</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Lucida Grande; min-height: 16px; ; font-family: Lucida Grande; font-size: 13px; "><BR style="font-family: Lucida Grande; font-size: 13px; "></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">Dr.<SPAN class="Apple-converted-space"> </SPAN>Edgardo<SPAN class="Apple-converted-space"> </SPAN>Schapachnik</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">President<SPAN class="Apple-converted-space"> </SPAN>of<SPAN class="Apple-converted-space"> </SPAN>Steering<SPAN class="Apple-converted-space"> </SPAN>Committee</DIV><DIV><BR class="khtml-block-placeholder"></DIV><DIV><BR class="khtml-block-placeholder"></DIV><BR class="Apple-interchange-newline"></SPAN> </DIV><BR></DIV></BODY></HTML>