What laboratory tests can be done to confirm the diagnosis of syncope?

  (A) stimulation test: 1. Carotid sinus stimulation and carotid artery compression test. The examiner first massages the patient’s unilateral carotid sinus with the thumb, alternating between left and right, and if needed, bilateral carotid sinus can be massaged at the same time, each massage time is 30 seconds, if there is a positive reaction immediately stop massage, such as a negative reaction, that is, the patient’s carotid artery is compressed with the thumb, alternating between left and right, the general duration of compression is 30 seconds. If there is a positive reaction generally in 10-30 seconds can appear abnormal. The above test should be done while closely observing the patient’s clinical performance, monitoring blood pressure, electrocardiogram and electroencephalogram, once abnormalities are found, the carotid massage or compression should be terminated. This test should be performed under the conditions of resuscitation equipment and drugs to prevent unpredictability.  2, both eyes also need compression method: the examiner to thumb and forefinger compression of the patient’s eyeballs, a positive person in 10 to 15 seconds can appear fainting. Weakness, high myopia and serious heart disease is prohibited.  3, blowing Zhang method: patients lying or sitting, routine ECG and / or EEG examination, the patient is asked to inhale deeply and then tightly closed mouth and nose, immediately hold the breath, but also hard exhaust, 15 seconds after the ECG and / or EEG review, the appearance of various heart rhythm disturbances or brain waves for positive. Some patients may experience fainting or convulsions. A positive test can help in the diagnosis, but a negative test cannot exclude syncope.  (B) Auxiliary examinations: ECG, cardiac ultrasound and other examinations are generally applicable to all types of cardiogenic syncope and reflex syncope; EEG is applicable to cerebral syncope, cardiogenic and reflex syncope; Doppler ultrasonography of carotid and vertebral arteries, cerebral angiography, cranial CT and cerebrospinal fluid examination are applicable to cerebral syncope. There are also cervical spine films and chest films, blood glucose and lipids can be examined as appropriate.