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People with the following are also at higher risk: Known ischemic heart disease, structural heart disease, previous arrhythmias or reduced ventricular function Brief palpitations or sudden loss of consciousness Fainting during exertion Fainting while flat on ones back Low number of fainting episodes (one or two) Abnormal heart exam Family history of inheritable conditions or premature sudden cardiac death (younger than age 50) Presence of known congenital heart disease Initial evaluation Anyone with syncope should receive an initial evaluation, including a detailed physical exam, medical history and blood pressure and heart rate check by a health care professional