Related Subjects:
|Transient Loss of Consciousness
|Vasovagal Syncope
|Syncope
|Aortic Stenosis
|First Seizure
|Carotid Sinus Syncope
The immediate management of syncope or impending
syncope is to lie the patient down and raise their legs
increasing cerebral blood flow.
About
Pathophysiology
Clinical features
Causes
Type Details
Vasovagal syncope Clinical context - vasovagal often situational - church, standing in line, hot bath, on toilet having severe gastroenteritis and usually sitting up or standing. Vasovagal usually hearing goes distant with tinnitus as does vision and sense of impending syncope. The patient goes pale. Then rapidly spontaneously recover once they go to the ground. Flushed and sweaty but not confused. May have urinary incontinence. May jerk. Ask about precipitants, standing, fear, venesection, micturition
or pain. Postural syncope (fainting on standing) Seen in patients
with autonomic disorders, salt and water depletion,
hypovolaemia or due to certain drugs especially
antianginal and antihypertensive medication.
Cardiac arrhythmias may reduce CO and result in syncope. This may occur
in bradycardias or tachycardias (inadequate ventricular
filling time). The loss of consciousness occurs
irrespective of the patient posture. A Stokes-Adams
the attack is a loss of consciousness related to a sudden
loss of ventricular contraction particularly seen during
the progression from second to third-degree heart
block.
Carotid sinus syncope A rare condition mainly seen
in the elderly. As a result of hypersensitivity of the
carotid sinus, light pressure, such as that exerted by
a tight collar, causes severe reflex bradycardia and
hence syncope.
Exertional syncope occurs in aortic valve or subvalve
stenosis. The syncope results from an inability of the
heart to increase cardiac output in response to increased
demand.
Cardiac Causes of syncope
Clinical
Investigations
Management
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Syncope
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