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Current guidelines recommend echocardiography (echo) for syncope patients only when they have known heart disease or abnormal findings on physical examination or electrocardiograms (ECGs; J Am Coll Cardiol 2017; 70:e39). Investigators at a single large teaching hospital in Pennsylvania retrospectively examined the diagnostic yield of echo in 139 patients (80% older than 65) who presented with syncope (90% with no prior syncope). All patients received ECGs and echos. Abnormal ECG was defined as abnormal axis, ischemic changes, atrioventricular blocks, abnormal QTc interval, or left bundle branch block. Abnormal echo findings were defined as low ejection fraction (<45%), valve abnormalities, ventricular hypertrophy, outflow tract obstruction,…