1 / 13

Syncope

Syncope. Jeffrey Chen 7/6/09. Syncope. Definition: Abrupt loss of consciousness and postural tone that reverses without intervention. Differential Diagnosis. Cardiac Non-Cardiac Neurological Systemic/Metabolic Psychiatric Other Neurocardiac (Vasovagal). Cardiac.

leilani-davidson
Download Presentation

Syncope

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Syncope Jeffrey Chen 7/6/09

  2. Syncope • Definition: Abrupt loss of consciousness and postural tone that reverses without intervention.

  3. Differential Diagnosis • Cardiac • Non-Cardiac • Neurological • Systemic/Metabolic • Psychiatric • Other • Neurocardiac (Vasovagal)

  4. Cardiac • Structural Abnormalities • Cardiomyopathy (hypertrophic, restrictive, dilated) • Aortic Stenosis • Myocarditis • Pulmonary Hypertension • Postop Congenital heart disease (ex. Fontan) • Congenital coronary abnormality • Electrical Disorders • Long QT syndrome • WPW syndrome • AV block • Ventricular tachycardia • Ventricular Fibrillation

  5. Non Cardiac • Neurologic • Seizures • Migraine Headaches • Transient Ischemic Attacks • Acute Vestibular Syndrome

  6. Non Cardiac • Systemic/Metobolic • Hypoglycemia • Electrolyte Abnormalities • Drugs/Toxins • Carbon Monoxide • Endocrinopathies

  7. Non-Cardiac • Psychiatric • Panic Attacks/Hyperventilation • Conversion Reaction • Depression

  8. Non-Cardiac • Other • Situational syncope • Cough • Micturation • Defecation • Neck stretching • Hair grooming • Breath Holding Spells

  9. Neurocardiac (Vasovagal) • Most Common variety of syncope • 25% precipitated by acute illness and anemia or by noxious stimuli (fear, pain, exhaustion) • Prodromal symptoms • nausea/vomiting • Lightheadedness/vertigo • Visual disturbances • Sweating • SOB • Mental alertness following the episode helpful in distinguishing from seizure

  10. Neurocardiac (vasovagal) cont. • Caused by: 1. venous pooling which 2. leads to vigorous contractions of an underfilled ventricle 3. This stimulates ventricular mechanoreceptors which produces a paradoxic withdrawal of sympathetic activity 4. leading to hypotension, bradycardia or both

  11. Management • Goal is to increase circulating volume • Increased fluid intake • Mention potential diuretic effect of caffeine • Use more salt or salt tablets • Elastic Stockings • Stress importance of “paying attention” to the warning signs • Avoid Noxious stimuli • Lying down before losing consciousness

  12. Management • Medications • Mineralocorticoids (hydroflurocortisone) • Beta-blockers • Alpha-agonists • Serotonin agonists

More Related