Collapse Flashcards
What are the three broad categories of causes of collapse? (NB - memory aid)
The 3 Ss
Syncope (faint) - non/cardiac and cardiac - eg. aortic stenosis, arrhythmia, HOCM, PE/MI
Seizure (neurological)
pSychiatric
How often to TIAs present as collapse?
Rarely
Which systems should you focus on particularly during top-to-toe clinical examination?
Neurological and cardiac
Are are the 3 most common cardiac causes of collapse (from syncope)?
And 2 less common cardiac causes?
Arrhythmia - bradycardia in Strokes-Adams attack, also drug causes of bradcardia
Valvular - aortic stenosis
Congenital - HOCM
ACS, aortic dissection
What signs, other than an abnormal ECG, might point you towards a cardiac cause, rather than a neurological one?
Absence of nausea and vomiting No warning (aura) Sudden drop with reduced consciousness Has some memory and not confused Flushing Dizziness Palpitations Quick recovery
What are the non-cardiac causes of syncope?
Drugs Simple (vasovagal, situational e.g. cough, micturition) Infection Metabolic Neurological Other (PE rare)
What are the 2 main methods by which drugs cause syncope (and which ones do it?)
Mem aid
Postural hypotension: diuretics, antihypertensives (incl betablockers)
Bradycardia - betablockers, amiodarone, digoxin
(BAD bradycardia)
What is the cause of a true faint?
Vasovagal
Which 2 infections are most likely to cause collapse?
UTI
Pneumonia
What are the 4 main metabolic causes of collapse?
Hyperglycaemia
Hypoglycaemia
Hyponatraemia
Failure
Which investigations should you ask for?
Glucose FBC CRP U + E (look for hyponatraemia) LFT Bone CK (to assess how long on floor for) Troponin, D dimer (if chest pain) O2 sats ECG (important) Urinalysis (UTI) CXR
What must you think about when discharging a patient after collapse?
Should they be driving?
