SIM Week 4 Flashcards
PE for Syncope?
vitals, orthostatic vitals, neuro exam, CV exam, pulmonary exam
Lab tests for Syncope?
telemetry (long QT, arrhythmia), pulse oximetry, 12-lead EKG (ischemia, conduction blocks), CBC, glucose, (urine HCG), BNP
Classification of Syncope?
neurally (reflex) mediated, cardiogenic, autonomic dysfunction, other
Define Syncope
transient LOC secondary to cerebral hypoperfusion characterized by rapid onset, short duration and complete spontaneous recovery
Neurally Mediated Syncope
Vasovagal, Situational, Carotid Sinus
pain, fear, emotional distress, prolonged standing lead to what type of syncope?
vasovagal (neural)
urination, defacation, coughing, sneezing, swallowing, exercise, weight lifting, others to what type of syncope?
situational (neural)
shaving, massage (what type of syncope)
carotid sinus (neural)
Types of Cardiogenic Syncope
structural ds, arrhythmias
Autonomic Dysfunction causing syncope
standing quickly or prolonged standing, postprandial, heat exposure, following cessation of exercise
Cardiogenic cause of syncope
syncope during prone, during exercise, palpitations, startling (such as alaram clock, siren, etc), more likely prolonged QT syndrome
Define Vtach
3 or more consecutive beats of ventricular origin (wide QRS) at rate 100-200bpm
Causes of Vtach
coronary artery ds, cardiomyopathy, electrolyte abnormalities, MI, hypoxemia, acidosis, idiopathic
Tx of Vtach-unstable
immediate synchronized cardioversion; 100 joules and repeat at increasing intervals 200, 300, 360
Tx of Vtach-stable
amiodarone, plan for elective synchronized cardioversion
