Syncope Flashcards
Define syncope
clinical syndrome with transient loss of consciousness secondary to inadequate cerebral nutrient flow
Define pre-near syncope
lightheadedness, feeling unstable, dizzy, nausea, feeling hot or cold
How to determine of someone experienced true syncope
- frequency or duration of episodes
- position before the episode
- witnessed signs or provoking factors
- pre-existing conditions
What are some diagnostic tests that could be used in the case of syncope
-ECG
-transthoracic echo
-neuro test
-stress test
-carotid massage
-tilt test
Management of syncope
-based on underlying cause to prevent injury/death from recurrent episodes
-state based driving restrictions
What position is someone usually in before reflex syncope
upright
What position is someone usually in before orthostatic syncope
changing positions
What position is someone usually in before syncope related to cardiac arrhythmia
supine
Define reflex syncope
neurally mediated, mixed hemodynamic response
- vasovagal, situational, carotid sinus syndrome
- absence of heart dz
Define vasovagal syncope
syncope in response to emotion/pain, unknown trigger, usually some warning symptoms
- efferent vasodepressor reflexes resulting in decreased peripheral vascular resistance
Describe the symptoms of vasovagal syncope
nausea, diaphoresis, graying out of vision, normal BP response to standing
Define situational syncope
syncope in response to a situation such as micturition, defecation, swallowing, coughing/sneezing, eating
Define carotid sinus syndrome
syncope following abrupt neck movement or stimulation of the carotid
What are some cardiovascular causes of reflex syncope
tachy/brady arrythmias, structural diseases, cardiopulmonary/vascular causes
Define orthostatic syncope
syncope following change in position
-can be med related or secondary to volume depletion or autonomic failure
What can you treat orthostatic syncope with
- treat underlying condition
- fludrocortisone
Describe pediatric syncope
- usually benign alterations in vasomotor tone
- can be life threatening if secondary to cardiac etiology
What is the most common cause of syncope in peds
vasovagal syncope, secondary to breath holding spells (triggered by emotion)
Describe POTS (postural tachycardia syndrome)
excessive increase in HR with standing, no arterial hypertension
- palpations, anxiety, dizziness, tremulousness
