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SYNCOPE

SYNCOPE. Prof JD Marx. DEFINITION. Short transient episode of loss of consciousness. ETIOLOGY. 1. CARDIAC. 2. NEUROGENIC. 3. NEURO-CARDIOGENIC SYNCOPE. 4. OTHER. 1. CARDIAC. a.) Structural Heart Disease  Hypertrophic obstructive cardiomyopathy.  Aortic stenosis.

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SYNCOPE

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  1. SYNCOPE Prof JD Marx

  2. DEFINITION Short transient episode of loss of consciousness

  3. ETIOLOGY 1. CARDIAC 2. NEUROGENIC 3. NEURO-CARDIOGENIC SYNCOPE 4. OTHER

  4. 1. CARDIAC a.) Structural Heart Disease Hypertrophic obstructive cardiomyopathy

  5. Aortic stenosis

  6.  Mitral stenosis

  7.  Myxoma LA

  8. Aortic dissection

  9. 1. CARDIAC b.)Dysrhythmias •  Tachy-arrhythmias • Ventricular • Supraventricular •  Brady-arrhythmias • AV Block

  10. 1. CARDIAC c.)Other  Orthostatic hypotension  Drugs

  11. 2. NEUROGENIC • a.) Epilepsy • b.) TIA • c.) Autonomic neuropathy •  Diabetes mellitus • Shy Drager syndrome

  12. a.) Carotid sensitivity • b.) Situational syncope •  Cough •  Micturition 3. NEURO-CARDIOGENIC SYNCOPY

  13. a.) Pulmonary Embolism b.) Vertigo (BPPV) 4. OTHER

  14. c.) Differential Diagnosis

  15. NO YES SPECIAL EXAMINATIONS Obtain history of patient and witness, physical examination, 12-lead ECG ECG with carotid sinus massage Do the findings suggest a cardiac diagnosis? • Consider • Ambulatory ECG • Echo • Electrophysiological Study Do the findings suggest a neurological diagnosis? YES NO • Consider • EEG • Carotid doppler • CT/MRI brain scan • Consider • Tilt test

  16. 1. Underlying Condition • 2. Neurocardiogenic syncope • Β blocker • Disopyramide • Tricyclic antidepressants TREATMENT

  17. Thank You

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