Cardio - Syncope Flashcards

1
Q

what are the 4 main types of syncope?

A
  1. Reflex syncope: temporarily decreased HR and BP… reduced cerebral perfusion.
    - vasovagal syncope
    - carotid sinus hypersensitivity
    - situational syncope (e.g. micturition)
  2. Cardiac syncope: cardiac pathology causes reduction in CO.
    - arrythmias (more common in middle-aged pts)
    - structural cardiac pathology causing outflow obstruction (e.g. aortic stenosis, hypertrophic obstructive cardiomyopathy)
    - massive PE
  3. Orthostatic syncope: reduced intravascular volume or blunted autonomic response… low BP on sitting/standing… decreased cerebral perfusion.
    - dehydration
    - drugs
    - autonomic instability
    - baroreceptor dysfunction (in hypertensive pts)
  4. Cerebrovascular syncope (rarer): non-cardiac structural causes of reduced cerebral perfusion.
    - vertebrobasilar insufficiency
    - subclavian steal
    - aortic dissection
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2
Q

suggest possible drugs that can cause syncope

A
  • diuretics and ACEi: reduced blood volume and vasodilation
  • B-blockers: inability to increase HR on standing
  • a-blockers: inability to vasoconstrict major capacitance vessels
  • CCBs: inability to vasoconstrict and some are negatively inotropic/chronotropic
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3
Q

what is the most common cause of syncope in:

  • younger pts?
  • older pts?
A
  • young: vasovagal syncope

- old: drugs

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4
Q

what is the common cause of syncope that has no warning?

A

cardiac arrythmia (some may have palpitations) or massive PE

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5
Q

what is the common cause of syncope preceded by dizziness, pallor, clamminess?

A

vasovagal syncope

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6
Q

how long does LoC in vasovagal/cardiac syncope last vs epileptic seizure?

A

syncope: seconds
seizure: can last minutes

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7
Q

how long does it take to recover in vasovagal or cardiac syncope and seizure?

A
  • vasovagal: rapid recovery on sitting or lying
  • cardiac: rapid spontaneous recovery
  • seizure: confusion for 5-30 mns
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8
Q

which Ix should be performed on anyone with LoC?

A
  1. O2 sats - may reveal hypoxia, e.g. in PE
  2. Bloods:
    • capillary blood glucose - ?hypoglycaemia
    • FBC - ?anaemia
    • UandE - ?electrolyte abnormality
  3. ECG - ?arrythmia
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