Shortness of breath, chest pain, palpitations, exercise-associated syncope
Organic heart disease
May have bradycardia or tachycardia, cyanosis
Organic heart disease
Diagnostics for Organic heart disease?
Palpitations; absence of other symptoms
Loud S2, S3; murmur, lift
Diagnostics for Arrhythmias
Electrocardiogram, Holter monitor, echocardiogram Doppler studies, cardiac stress testing
Emotional event, standing for long periods, crowded room, warm environment
Physical Findings for Vasovagal?
Diagnostics for Vasovagal?
Tilt-table testing, CSM
Occurs with cough, micturition, defecation, swallowing
Physical Findings for Situational?
Diagnostics for Situational?
Children 6 mo to 5 yr; associated with anger, pain, brief cry; breath-holding LOC; may have twitching
Cyanosis or pallor
Diagnostics for Breath holding?
Anxiety- or fear-induced event, shortness of breath
Physical Findings for Hyperventilation?
Diagnostics for Hyperventilation?
History of asthma; coughing paroxysm awakens child from sleep, becomes flaccid with clonic muscle spasm, LOC
Physical Findings for Cough syncope?
Diagnostics for Cough syncope?
Position change from lying/sitting to standing, pregnancy, prolonged bed rest
Hypotension on testing orthostatic blood pressure
Diagnostics for Orthostatic hypotension?
20-mm Hg drop insystolic pressureon standing
History of antidepressants, antiarrhythmic agents, (B-blockers, or diuretics
Depends on underlying condition
Diagnostics for Prescribed medications?
History of use of illicit drugs
Arrhythmia may be present
Diagnostics for Drug-induced causes?
Headache, vomiting, photophobia, positive family history
Usually none; nystagmus, photophobia
Diagnostics for Migraine?
Convulsions, incontinence, postictal phase
Usually none; nystagmus
Diagnostics for Seizures?
Symptoms consistent with depression, anxiety, panic
Physical findings Mental disorder?
Diagnostics for Mental disorder?
Adolescent, event occurs with audience present; gentle fall, memory of incident exact
Physical findings hysterical reaction?
Diagnostics for Hysterical reaction?
No diagnostic characteristics
Physical findings of unknown causes?
Diagnostics for Unknown Causes?
Workup normal results