Syncope Flashcards
syncope when you stand up
think Orthostatic hypotension
syncope when shaving
think, Carotid sinus hypersensitivity
syncope during an argument in an “older patient”
-think, Myocardial ischemia
syncope in a child during an argument
-thin, long QT (get EKG)
syncope with prolonged, motionless standing (soldier)
-Neurocardiogenic (vasovagal), order Tilt Table Test
orthostatic hypotension numbers
a drop in systolic BP of 20 sitting to standing
a drop in diastolic BP of 10 sitting to standing
always check 3 positions, supine, sitting, standing
How do you usually tx orthostatic hypotension?
-fluids
What exam would you perform in someone that faints while shaving? And what must you do before you do the carotid sinus massage?
- Carotid sinus massage checking for carotid hypersensitivity
- auscultate the carotids before to check for a bruit, you could cause a stroke if there is a bruit
75 y.o. passes out while having an argument with his landowner over money. What 3 conditions should you rule out first?
-Acute coronary syndrome, ventricular arrhythmia, and aortic stenosis
13 y.o boy passes out while have an argument with his principal. His exam is normal. What heart conduction condition do you suspect?
-Long QT syndrome
you suspect neurocardiogenic syncope (vasovagal), what test do you order?
-table tilt test
Upon auscultation of a patient’s carotid artery you note the patient’s heart rate became bradycardia and the patient had a long three second pause. What is the suspected underlying cause?
-Carotid sinus hypersensitivity
A 30 y.o. male has syncopal event three days after taking an antibiotic. EKG at he scene reveals ventricular tachycardia. What disease condition do you suspect?
-Acquired long QT syndrome due to the antibiotic or medication
A 24 y.o. has a syncopal event. EKG demonstrates a short PR interval with an upswept initial QRS. What underlying condition caused this syncope?
-Wolfe Parkinson White
Tilt table is use to Dx what syncopal condition:
-neurocardiogenic–vasovagal
