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dear friends dear colleagues I would like to start with the expression of thanks to the organizers although the title was a real headache for me it is an attractive but very tricky title it sounds good but it is not really clear what does it mean negative evaluation what kind of evaluation is negative or was it performed by pediatrician emergency specialist syncope specialist was it a primary cardiac evaluation or Advanced cardiac evaluation or a non-cardiac evaluation therefore in my talk I would like to share with you how the structure of care determines the meaning of negative evaluation what are the helpful red flags and score to diagnose cardiac Syncopy how to evaluate these red flags and what happens if even cardiac evaluation is negative basic evaluation consists of History taking physical examination and ECG if it is positive so there is a suspicion of cardiac syncope then cardiac evaluation is needed if it is negative the patient will not refer to the cardiologist it means tha
