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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 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
1. CARDIAC b.)Dysrhythmias • Tachy-arrhythmias • Ventricular • Supraventricular • Brady-arrhythmias • AV Block
1. CARDIAC c.)Other Orthostatic hypotension Drugs
2. NEUROGENIC • a.) Epilepsy • b.) TIA • c.) Autonomic neuropathy • Diabetes mellitus • Shy Drager syndrome
a.) Carotid sensitivity • b.) Situational syncope • Cough • Micturition 3. NEURO-CARDIOGENIC SYNCOPY
a.) Pulmonary Embolism b.) Vertigo (BPPV) 4. OTHER
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
1. Underlying Condition • 2. Neurocardiogenic syncope • Β blocker • Disopyramide • Tricyclic antidepressants TREATMENT