A doctor will note the medical and family history and symptoms before conducting a physical examination.
A slow pulse, especially if it is irregular, may be a sign of sick sinus syndrome. In this case, the doctor may order a Holter monitor test to record the heart's electrical activity over a 24-hour period as the person goes about regular activities.
Another test the doctor may order is tilt-table testing. This is usually recommended for people who have a history of fainting for an unknown reason and don't have any structural heart disease. During this test, blood pressure and heart rate are continuously monitored while the person lays on a mechanized table that is tilted at a 60-degree to 80-degree angle for 15 to 20 minutes at each angle. If the person’s blood pressure doesn't increase, a drug is given intravenously to raise the heart rate by approximately 20 beats a minute, at which point the test is repeated.