Syncope

Question 1

Syncope may be defined as

Answer 1

transient loss of consciousness due to global cerebral hypoperfusion with rapid onset, short duration and spontaneous complete recovery

Question 2

What is Reflex syncope

Answer 2

neurally mediated syncope

Includes, vasovagal, situational or carotid sinus syncope.

Question 3

Describe vasovagal syncope

Answer 3

triggered by emotion, pain or stress. Often referred to as ‘fainting’

Question 4

Situational syncope may be mediated by?

Answer 4

Cough, micturition, gastrointestinal

Question 5

Causes of orthostatic syncope?

Answer 5

primary or secondary autonomic failure
drug-induced
volume depletion

Question 6

Causes of primary autonomic failure

Answer 6

Parkinson’s disease, Lewy body dementia

Question 7

Causes of secondary autonomic failure

Answer 7

Diabetic neuropathy, amyloidosis, uraemia

Question 8

Causes of drug - induced orthostatic syncope

Answer 8

diuretics, alcohol, vasodilators

Question 9

Volume depletion orthostatic syncope

Answer 9

haemorrhage, diarrhoea

Question 10

Cardiac syncope causes

Answer 10

arrhythmias

structural: valvular, myocardial infarction, hypertrophic obstructive cardiomyopathy
others: pulmonary embolism

Question 11

Most common cause of syncope in all age groups

Answer 11

Reflex syncope

Question 12

orthostatic and cardiac causes become progressively more common in older patients.

Answer 12

true

Question 13

Evaluation of syncope includes

Answer 13

cardiovascular examination
postural blood pressure readings
ECG
carotid sinus massage
tilt table test
24 hour ECG

Question 14

Describe findings of postural blood pressure

Answer 14

a symptomatic fall in systolic BP > 20 mmHg or diastolic BP > 10 mmHg

or decrease in systolic BP < 90 mmHg

considered diagnostic of syncope

Question 15

Orthostatic hypotension is more common in

Answer 15

older people and patients who have neurodegenerative disease (e.g. Parkinson’s) diabetes, or hypertension