Syncope Flashcards
What is the lifetime prevalence of syncope?
3-37%
What percentage of ER visits are related to syncope? What percentage of hospital admissions?
3%
1%
Which age groups are most likely to have a syncope episode?
Younger (10-30)
Old (>65)
What are the three major categories of syncope?
Neurally mediated (Reflex) syncope Cardiogenic syncope Autonomic dysfunction syncope
What causes reflexive syncope?
A functional working nervous system
What type of syncope are vasovagal, situational, and carotid sinus syncope?
Reflexive syncope
What is the response to pain/fear/stress in a vasovagal reflex?
Decreased sympathetic
Decreased parasympathetic
Decreased HR and BP
What situations are included in Situational syncope?
Urination, defecation, coughing, sneezing, exercise, etc.
What situations can cause carotid sinus syncope?
Shaving
Massage
Which cardiogenic anomalies can cause syncope?
Arrhythmias
Structural disease
What is an inherited disease causing ventricular tachyarrhythmias in structurally normal hearts?
Brugada Syndrome
What causes autonomic dysfunction syncope?
Dysfunctional nervous system
What are examples of primary autonomic failure?
Lewy body disease (multiple system atrophy)
Parkinson Disease
What are examples of secondary autonomic failure?
Diabetic neuropathy
Amyloid neuropathy
Spinal cord injury
What are other causes to autonomic dysfunction?
Medications
Alcohol, exercise, post-prandial (lunch)
Orthostatic hypotension
How is Vtach diagnosed?
3+ consecutive ventricular originated beats
Tachycardia (100-200 bpm)
What is the difference between stable and unstable Vtach?
Stable is asymptomatic
How is unstable Vtach treated?
Give ‘em the joules!!!
Immediate synchronized cardioversion
What are treatment options for stable Vtach?
Amiodarone
Implantable Cardioverter-Defibrillator (ICD)
Beta blockers
What is treatment is used in acute V fib?
Joules
Can use lidocaine or procainemide
What is the long term treatment for V fib?
Amiodarone
Beta blocker
Implantable Cardioverter Defibrillator (ICD)
