Syncope Flashcards
Define syncope
- term used to describe the event of temporarily losing consciousness due to a disruption of blood flow to the brain, often leading to a fall
- Syncopal episodes are also known as vasovagal episodes/fainting
Describe the pathophysiology of syncope
Strong stimulus in vagus nerve→ parasympathetic NS stimulated → Counteracts sympathetic NS → blood vessels delivering blood to brain vasodilation → Cerebral circulation BP drops → hypoperfusion of brain
What are the signs and symptoms of syncope?
→ prodromal - what the patient felt prior to the attack → Hot or clammy/ sweaty/ heavy/ light headed/dizzy/blurry vision/headache
→ Suddenly losing consciousness and falling to the ground
→ Unconscious on the ground for a few seconds to a minute as blood returns to their brain
→ There may be some twitching, shaking or convulsion activity, which can be confused with a seizure
What is primary syncope?
Simple fainting
What are causes of primary syncope?
→Dehydration
→Missed meals
→Extended standing in a warm environment, such as a school assembly
→A vasovagal response to a stimuli, such as sudden surprise, pain or the sight of blood
What are causes of secondary syncope?
→ Hypoglycaemia
→ Dehydration
→ Anaemia
→ Infection
→ Anaphylaxis
→ Arrhythmias
→ Valvular heart disease
→ Hypertrophic obstructive cardiomyopathy
What investigations do you do for syncope?
- History + exam
- ECG: arrhythmia + QT (long QT)
- 24 hr ECG: if paroxysmal arrhythmias suspected
- Echocardiogram: structural heart disease
- Bloods: FBC (anaemia), U+E (arrhythmias + seizures), BG (diabetes)
How do you treat syncope?
→ avoid triggers
→ Avoid dehydration
→ Avoid missing meals
→ Avoid standing still for long periods
→ When experiencing prodromal symptoms such as sweating and dizziness, sit or lie down, have some water or something to eat and wait until feeling better
