Syncope Flashcards
What is syncope attributed to?
Cerebral Hypotension
What is Syncope?
Sudden loss of consciousness and posture with spontaneous recovery
How is Orthostatic BP taken for someone experiencing syncope?
Check BP supine, sitting and standing after 3 min
Postitive if:
- SBP drops >20
- DBP drops >10
What are the cardiac signs that can indicated syncope?
- Abnormal heart rhythm/murmurs/
- PMI
- Carotid bruits
What labs would you order for syncope?
- CBC
- BMP
- Troponin
What additional diagnostic tests can you give to someone with abnormal HR or arrhythmia
- EKG
- Holter/Diary 24-72 hr
- External loop recorder
- External patch
What is the Tilt table and who is this reserved for?
- Reserved for ppl experiencing recurrent, unexplained syncope
- Tests for vasovagal syncope
What is the benefit behind using the Tilt table?
Can be helpful in teaching patients to recognized symptoms (dizziness, lightheadedness)
What are the three types of Neurally-Mediated Syncopes?
- Vasovagal Syncope
- Situation syncope
- Carotid Sinus syncope?
What is the most common type of syncope?
Vasovagal Syncope
What are some common triggers of Vasovagal syncope?
Heat exposure
Prolonged standing
Physical exertion
What are some examples of Situational syncope?
Micturition
Cough
Swallow
How is Vasovagal Syncope usually treated?
- Avoid triggers
- Educate with counter pressure maneuvers (tilt training)
- Avoid salt and watch water intake
What are the causes associated with Carodit Sinus Syndrome
- Shaving
- Tight neck collar
- Prior head and neck surgery
What is Carotid Sinus Syndrome characterized as?
Drop in BP by 50 mmHg or more
OR Sinus pause of more than 3 seconds
Treatment for Carotid Sinus syndrome
Avoid triggers and consider pacing to relax
What is the Classic definition of Orthostatic Syncope?
Measure of BP 3 min after supine to standing
Drop in SBP of 20mmHg or more
OR
Drop in DB of 10 mmHg or more
What are the causes of Orthostatic Syncope?
- Hypovolemia
- Medications
- Autonomic Dysfunction
What are some treatments for Orthostatic Syncope?
- If due to dehydration give IV fluids and watch salt intake
- If drug related, remove drug
- Tilt training
What are the most common causes of Obstructive Cardiovascular Syncope?
- Aortic Stenosis (most common)
- Aortic dissection
- Hypertrophic cardiomyopathy
- PE
- Cardiac tamponade
What is the treatment plan for Cardiovascular Syncope?
- Possible pacemaker to fix arrhythmias
2. Anti-arrhythmics
What are some signs that would signify a seizure more than syncope?
- Lateral tongue bitting
- Head turning
- Hypersalivation
What is one useful test to determine Psedo syncope?
Arm drop test
Which type of syncope is considered the most dangerous with the highest mortality rate?
Cardiovascular syncope