Syncope

Question 1

San Francisco Syncope Rules

Answer 1

Predicts serious outcome at 7 days post presentation with syncope.
C - Hx CHF
H - Hematocrit <30%
E- ECG changes (new)
S - SBP<90, SBP>180mmHg
S - SOB at triage
Any ‘yes’ can’t consider low risk (96% sens, 62% specific)

Question 2

High Risk Pt’s

Answer 2

Age >55
Hx CCF/CAD
No prodromal sx/seated
VEB
Abnormal ECG
Fhx sudden cardiac death
Significant trauma from syncope

Question 3

Cardiac syncope RF

Answer 3

No warning/prodromal xs
Preceeding palpitations
On exertion/supine
Fam hx sudden cardiac death

Question 4

Causes of Cardiac Syncope

Answer 4

WOBBLIER
W - WPW - short PR interval
O - Obstructed AVN (2nd/3rd deg Hb)
B - Brugada synd - Coved STE, Saddleback STE
B - Bifasicular/Trifasicular block
L - LVH/HOCM - Dagger T/ ASD
I - Ischaemia
R - Repolarisation