Syncope Flashcards
Define syncope.
Temporary loss of consciousness and
postural tone due to transient cerebral
hypoperfusion, followed by spontaneous
recovery.
What 3 things determine stroke volume?
SV
- Contractility
- Preload
- Afterload
What cardiovascular syncope etiology is involved with tachy and bradyarrhythmias?
Electrical
What cardiovascular syncope etiology is involved with Tetralogy of Fallot, valve stenosis, MI, myxomas, vasospasm?
Mechanical: obstructive phenomena
What cardiovascular syncope etiology is involved with prolonged standing, heat, pain, sight of blood, emotion?
Reflex-Mediated Neurocardiogenic
Describe the Bezold-Jarisch Reflex.
- A trigger (prolonged standing) decreases venous return to the heart and decreased LV filling.
- Drop in preload encourages adrenergic response of the cardiovascular system increasing inotropy and chronotropy.
- The brain senses the increase in adrenergic response and increases vagal tone and decreases SANS tone which can lead to syncope.
Treatment for Neurocardiogenic syncrope.
Beta Blockers
What cardiovascular syncope etiology is involved with shaving, turning head rapidly, wearing tight collar?
Reflex-Mediated Carotid Sinus Hypersensitivity
What cardiovascular syncope etiology is involved with cough, micturition, valsalva, swallowing?
Reflex-Mediated Situational syncope
What cardiovascular syncope etiology is involved with pain in the oropharynx before fainting, pain in the tongue, or tonsillar fossa?
Reflex-Mediated Oropharyngeal Neuralgia
What cardiovascular syncope etiology is involved with overuse of an upper extremity.
Anatomical Subclavian Steal Syndrome
What cardiovascular syncope etiology is involved with standing or sitting up?
Orthostatic Hypotension
- drop in 20mmHg systolic and/or
- drop in 10mmHg diastolic
What 2 things are necessary to perform when a patient presents with syncope?
- H+P
2. 12 lead EKG
