Arrhythmia - Syncope

Question 1

Features suggestive of NON cardiac syncope

Answer 1

Question 2

Features suggestive of cardiac syncope

Answer 2

Question 3

syncope associated with amnesia

Answer 3

• Epilepsy

Question 4

Types of NonCardiac Syncope

Answer 4

Question 5

What is reflex syncope?

Answer 5

same with Neurally Mediated Syncope and Neurocardiogenic syncope

Question 6

normal response to Tilt testing

Answer 6

Question 7

tilt testing with neurally-mediated syncope

Answer 7

Question 8

What is Vasovagal syncope

Answer 8

Question 9

management for vasovagal syncope?

Answer 9

Question 10

what are physical counter-measure maneuvers

Answer 10

Question 11

midodrine for vasovagal syncope

Answer 11

Question 12

flurdrocortisone for vasovagal syncope

Answer 12

Question 13

pacemakers in vasovagal Syncope

Answer 13

Question 14

triggers for Carotid Sinus hypersensitivity

Answer 14

Question 15

Vasodepressor response in tilt testing

Answer 15

BP falls to a systolic value <60 mmHg. HR during syncope does not fall by more than 10% of its peak value.

Question 16

cardioinhibitory response

Answer 16

Cardioinhibitory syncope without asystole
- HR decreases <40 beats/min. for more than 10 sec; without asystole >3 sec. BP decreases before HR fall.

***with asystole if there is pause for >3sec

Question 17

role of pacemaker in vasodepressor and cardioinhibitory syncope?

Answer 17

in vasodepressor - not indicated

in cardioinhibitory - yes!

Question 18

what is tilt testing?

Answer 18

Tilt-testing enables the reproduction of reflex syncope in a laboratory setting. Positive responses in patients with neurally mediated syncope are 61%-69%, and specificity is high (92%-94%).

The most common indication for TTT is to confirm a diagnosis of reflex syncope in patients in whom this diagnosis has been suspected but not confirmed by the initial evaluation. This includes cases with a single unexplained syncope in a high-risk setting or those with multiple recurrent episodes when a cardiovascular cause has been reasonably excluded. TTT is also recommended when it is of clinical value to demonstrate susceptibility of the patient to reflex syncope.

Other indications for tilt-testing are discrimination between reflex syncope and orthostatic hypotension or falls, between TLOC with jerking movements and epilepsy, and in patients with frequent episodes of TLOC and suspicion of psychiatric problems

Question 19

Criteria for orthostatic hypotension

Answer 19

Question 20

tilt testing interpretation

Answer 20

Question 21

management for Orthostatic hypotension

Answer 21

acute water ingestion of 240ml of water
- peak effect 20mins after ingestion
- plain water only. no salt, no sugar

Question 22

role of compression garments for Orthostatic hypotension

Answer 22

Question 23

what is Postural Orthostatic tachycardia Syndrome

Answer 23

Question 24

What causes POTS?

Answer 24

Question 25

Management for POTS?

Answer 25

Question 26

what is Inappropriate Sinus tachycardia

Answer 26

Question 27

approach for IAST

Answer 27

Question 28

pharmacologic mgt for IAST?

Answer 28

Question 29

non-pharmacologic mgt for IAST?

Answer 29

Question 30

role of tilt testing

Answer 30

Question 31

medications use to improve sensitivity of tilt table testing

Answer 31

isoproterenol infusion vs sublingual nitrates

Question 32

example of cardioinhibitory syncope in TT

Answer 32

Question 33

example of POTS in TT

Answer 33

Question 34

example of POTS in TT

Question 35

example of Classic OH in TT

Answer 35

Question 36

example of psychogenic pseudosyncope in TT

Answer 36

Question 37

Driving and syncope

Answer 37

Question 38

best predictor of SCD

Answer 38

LVEF <30%

Question 39

Presenting rhythm in out-of-hospital arrest?

Answer 39

VT/VF

Question 40

Secondary prevention with ICD

Answer 40

Question 41

conditions that doesn't need ICD

Answer 41

Question 42

question?

Answer 42

3

Question 43

Answer 43

4