Syncope

Question 1

4 Causes of True Syncope

Answer 1

Naturally-mediated - VVS/CSS/Situational
Orthostatic - drug induced or ANS failure
Cardiac Arrhythmias
Structural Cardio-Pulmonary

Question 2

Seizure

Answer 2

Pass out epileptically, not true syncope

Question 3

Younger vs. Older Causes of Syncope (2 each)

Answer 3

VVS or situational vs. Orthostatic or drug-induced

Question 4

4 Causes of YA Syncope w/ Life-Threatening Associations

Answer 4

HCM
DCM/myocarditis
Channelopathies
WPW

Question 5

Supine and Upright BP

Answer 5

Orthostatic hypotension

Question 6

Insertable Loop Recorder

Answer 6

Implanted ECG monitor that gives 14 months worth of data for better chance of diagnosis

Question 7

HCM

Answer 7

1 cause of sudden death in YAs, often presents w/ syncope first

Question 8

Acute MI/Ischemia -> Syncope

Answer 8

Secondary neural reflex -> bradycardia, vasodilatation, etc

Question 9

Afib Syncope

Answer 9

Usually due to pause the follows conversion from Afib back to normal sinus rhythm

Question 10

5 Situationals

Answer 10

Post-micturition
Cough
Swallow
Defecation
Blood

Question 11

VVS Progression

Answer 11

Blood pools in legs,heart beats faster, brain slows HR and lowers BP -> faint and blood returns to brain

Question 12

Difference b/w VVS and Seizure Syncope

Answer 12

No post-ictal state in VVS

Question 13

Tilt-Table Test

Answer 13

Start at supine position and slowly rotate to standing - can tell neuro or orthostatic or some other syncopes

Question 14

General Treatment for VVS

Answer 14

Diet/fluids/salt

Question 15

Orthostatic Hypotension

Answer 15

Failure of ANS, most often w/ Parkinson’s. Very high supine BP and then very low standing, often w/ no change in HR

Question 16

3 Medications for Orthostatic Intolerance

Answer 16

Fludrocortisone, midodrine, erythropoietin