Scenario 2 - collapse

Question 1

If collapse is preceded by aura, what causes of collapse does this exclude?

Answer 1

Cardiac causes

Question 2

In a collapse, what mnemonic should you use for management?

Answer 2

ABCDEFG
Airway
Breathing
Circulation
Don't Ever Forget Glucose

Question 3

Which type of heart murmur is most likely to cause collapse?

Answer 3

Aortic stenosis

Question 4

In a collapse, what mnemonic should you use to guide your differential diagnosis?

Answer 4

3 Ps
Precipitating factor
Posture
Prodrome?
These are the 3 Ps of VASOVAGAL SYNCOPE

Question 5

Recall 3 cardiac causes of collapse

Answer 5

Postural hypotension
Outflow obstruction
Arrhythmias

Question 6

Recall 3 non-cardiac causes of collapse

Answer 6

Hypoglycaemia
Vasovagal syncope
Seizure

Question 7

What are the 2 possible causes of cardiac outflow obstruction, and what investigation could reveal these abnormalities?

Answer 7

Hypertrophic Obstructive Cardiomyopathy
Aortic Stenosis
Echocardiogram

Question 8

Recall 2 positive signs on examination of outflow obstruction

Answer 8

Ejection systolic murmur

Slow-rising pulse

Question 9

Which arrhythmia does Amir Sam say might cause collapse?

Answer 9

Long QT syndrome causing ventricular tachycardia

Question 10

How do you spot long QT syndrome on an ECG?

Answer 10

• Draw a horizontal line between the 2 R waves
• Draw a 2nd, vertical line halfway between the R waves
• If this line does not cross T wave = normal
• If the 2nd line intersects the T wave = long QT

Question 11

Which electrolyte imbalances may cause long QT syndrome?

Answer 11

Hypokalaemia

Hypomagnesaemia

Question 12

What is the first line in investigation for suspected long QT syndrome?

Answer 12

Cardiac monitor bed and 24 hour tape