Syncope

Question 1

Definition

Answer 1

Transient loss of consciousness and postural tone

Question 2

Aetiology/ causes

Answer 2

Caused by a temporary global failure of cerebral perfusion

All cases of cardiac syncope have the same general mechanism. When the heart fails to generate adequate cardiac output, the brain is inadequately perfused with freshly oxygenated blood and temporarily malfunctions, leading to the syncopal event

Ischaemic cardiomyopathy (most common structural cardiac aetiology of syncope)
Valvular abnormalities (second most common structural aetiology, most commonly aortic stenosis)

Non-ischaemic/Dilated cardiomyopathy (third most common structural aetiology)
Angina, CAD
Hypertrophic obstructive cardiomyopathy
Aortic dissection
Cardiac tamponade
Pericardial disease
Pulmonary hypertension/ emboli
Tachyarrhythmia

Question 3

Risk factors

Answer 3

Family history may increase risk
Heavily depends on the underlying condition)

Question 4

Epidemiology/ Population affected

Answer 4

Relatively common phenomenon encountered among patients of every age range, race, religion, and socioeconomic status

Question 5

Clinical presentation

Answer 5

FAINTING
Pale skin
Light-headedness
Tunnel vision- can see only the objects in front
Feeling warm
A cold, clammy sweat
Nausea
Yawning
Blurred vision

Question 6

Prognosis

Answer 6

Patients with easily treatable aetiologies of cardiac syncope will generally have a good prognosis with adequate treatment.

Patients with advanced heart failure and syncope, however, have a 45% one-year mortality

Question 7

DDX

Answer 7

The loss of consciousness could be caused by various other conditions or events