Loss of Conscious Flashcards
Cardio Causes
Aortic Stenosis Complete Heart Block VT SVT ACS
Resp Causes
PE
Neuro Causes
Seizures
Brain Tumour
Stroke/TI
Head trauma +/- bleed
Endocrine Causes
Hypoglycaemia
Addisonian Crisis
Hypotensive Causes
Vasovagal
Hypovolaemia
Anti-hypertensive meds
Autonomic disturbance due to diabetic neuropathy
Haematology Causes
Anaemia
Psychiatric Causes
Anxiety
Hyperventilation
Other
Carotid Sinus Hypersensitivity
Micturation/cough syncope
Bedside Ix
Lying and Standing BP
ECG
BM (<4)
Medication R/v
Bloods Ix
FBC, LFTs, UEs, CRP
Imaging
ECHO: structural heart disease
CT head: bleed, malignancy, trauma, stroke
Special Tests
24 hour tape cardiac monitoring
EEG + Neuro review if first fit
RED FLAGS
- Cardiac
Must rule out cardiac cause
- No prodrome
- Sudden LOC without warning
- No defensive injuries e.g. bruises on face
- PMHx IHD, structural heart disease, previous episodes
Must Ask Before?
What were they doing?
Any warning?
Any chest pain, palpitations, SOB?
Last thing you remember?
Must Ask During?
Did anyone witness?
Did you black out?
Any loss of continence, tongue biting (sides = epilepsy), visible fitting?
Must Ask After?
Any injury (esp.head)
On warfarin?
Quick recovery or post ictal?
PMHx Risk Factors
- For arrhythmia
Coronary artery disease High Blood Pressure Diabetes High cholesterol Sleep apnoea Family history of heart disease Advancing age (getting older)
Social Risk Factors
- For arrhythmia
Smoking Alcohol High Fat Diet/Obesity Stress Drug abuse
Non-modifiable RF
Family history of heart disease
Advancing age
