Syncope Flashcards
What is syncope?
Temporary loss of consciousness due to a disruption of blood flow to the brain
What are other terms for a syncopal episode?
Vasovagal episodes
Fainting.
What is the term used to refer to the way people felt prior to fainting?
Prodrome
What are the prodromal symptoms?
- Hot or clammy
- Sweaty
- Heavy
- Dizzy or lightheaded
- Vision going blurry or dark
- Headache
How can the causes of syncope be divided?
Into Primary and Secondary
What are the primary causes of syncope?
- Dehydration
- Missed meals
- Extended standing in a warm environment- school assembly
- A vasovagal response to a stimuli, such as sudden surprise, pain or blood
What are the secondary causes of syncope?
- Hypoglycaemia
- Dehydration
- Anaemia
- Infection
- Anaphylaxis
- Arrhythmias
- Valvular heart disease
- Hypertrophic obstructive cardiomyopathy
What are the possible cardiac causes of syncope?
- Arrhythmias
- Valvular heart disease
- Hypertrophic obstructive cardiomyopathy
What can occur during a syncopal episode that can cause confusion with a seizure?
Twitching, shaking or convulsion activity
What do you need to look for in a history of someone who has a syncopal episode?
- After exercise?
- Triggers?
- Concurrent illness?
- Injury secondary to the faint? Do they have a head injury?
- Associated cardiac symptoms, such as palpitations or chest pain?
- Associated neurological symptoms?
- Seizure activity?
- Family history, particularly cardiac problems or sudden death?
What are the features of a syncopal episode prior to the event?
Prolonged upright position before the event
Lightheaded before the event
Sweating before the event
Blurring or clouding of vision before the event
What happens to the body during a syncopal episode?
Reduced tone during the episode
Is there a prolonged post ictal period after a syncopal episode?
No
What should be done when someone presents syncopal episode?
Thorough examination
What do you need to check in someone who has just had a syncopal episode?
Check for:
• physical injuries as a result of the faint, for example a head injury?
• Is there a concurrent illness, for example an infection or gastroenteritis?
• Neurological examination
• Cardiac examination, specifically assessing pulses, heart rate, rhythm and murmurs
• Lying and standing blood pressure
What imaging can you do in someone after they have had a syncopal episode?
ECG
What would you check for in an ECG of someone who has just had a syncopal episode?
Arrhythmia The QT interval for long QT syndrome Paroxysmal arrhythmias (24 ECG)
When might you do an echocardiogram in someone who has had a syncopal episode?
If there might be a structural heart disease
What might you check for in the blood of someone who is presenting with a syncopal episode?
Full blood count: Anaemia
Electrolytes: arrhythmias and seizures
Blood glucose: diabetes
Who is fainting common in?
Children- especially young girls
What happens as a child who faints gets older?
They grow out of it
