Syncope

Question 1

What is the most common cause of syncope in children?

Answer 1

Vasovagal syncope (AKA vasodepressor or neurocardiogenic syncope)

Question 2

What is the recommended treatment for vasovagal syncope?

Answer 2

During the acute syncopal event, having the patient lie down should alleviate the symptoms. To prevent future occurrences, the patient should increase fluid and salt intake and decrease caffeine intake. If medications are warranted, Fludrocortisone and α-agonists have been used successfully.

Question 3

Which conditions and medications increase the likelihood of developing orthostatic hypotension?

Answer 3

Volume depletion, impaired autonomic nervous systems, vasodilators, antiarrhythmics, antidepressants, cocaine, and alcohol.

Question 4

What is POTS?

Answer 4

Postural Orthostatic Tachycardia Syndrome

Question 5

What are the two categories of cardiac dysfunction which can lead to cardiogenic syncope?

Answer 5

Obstructive heart lesions (severe AS, HCM, TOF, abnormal coronary arteries) and Arrhythmias (SVT, VT, sinus node dysfunction, AV block, long QT syndrome).

Question 6

If you suspect an arrhythmia as an etiology for syncope, what testing do you perform?

Answer 6

24 hour Holter and EKG

Question 7

What is the best test to order in a patient with recurrent, unexplained syncope?

Answer 7

EKG

Question 8

What are some (6) nonvascular etiologies for syncope?

Answer 8

Atypical seizures, migraines, hyperventilation, cough syncope, hysterical syncope, and sudden rises in intracranial pressure.