Syncope Flashcards
Syncope may be defined as
transient loss of consciousness due to global cerebral hypoperfusion with rapid onset, short duration and spontaneous complete recovery
What is Reflex syncope
neurally mediated syncope
Includes, vasovagal, situational or carotid sinus syncope.
Describe vasovagal syncope
triggered by emotion, pain or stress. Often referred to as ‘fainting’
Situational syncope may be mediated by?
Cough, micturition, gastrointestinal
Causes of orthostatic syncope?
primary or secondary autonomic failure
drug-induced
volume depletion
Causes of primary autonomic failure
Parkinson’s disease, Lewy body dementia
Causes of secondary autonomic failure
Diabetic neuropathy, amyloidosis, uraemia
Causes of drug - induced orthostatic syncope
diuretics, alcohol, vasodilators
Volume depletion orthostatic syncope
haemorrhage, diarrhoea
Cardiac syncope causes
arrhythmias
structural: valvular, myocardial infarction, hypertrophic obstructive cardiomyopathy
others: pulmonary embolism
Most common cause of syncope in all age groups
Reflex syncope
orthostatic and cardiac causes become progressively more common in older patients.
true
Evaluation of syncope includes
cardiovascular examination postural blood pressure readings ECG carotid sinus massage tilt table test 24 hour ECG
Describe findings of postural blood pressure
a symptomatic fall in systolic BP > 20 mmHg or diastolic BP > 10 mmHg
or decrease in systolic BP < 90 mmHg
considered diagnostic of syncope
Orthostatic hypotension is more common in
older people and patients who have neurodegenerative disease (e.g. Parkinson’s) diabetes, or hypertension