Background continued:

• So this is cardiogenic syncope until proved otherwise and regardless of what turns up on subsequent examinations, you already know that this patient will have to be admitted for immediate electrophysiologic testing.
• Coronary disease with a history of MI plus syncope will almost always require EP study to exclude a cardiogenic cause.
• Of course a patient with coronary disease CAN have neurocardiogenic or orthostatic hypotension but these are diagnoses made by exclusion after ventricular arrhythmia or AV conduction disease have been ruled out.