Clinical: Syncope Flashcards Preview

Cardio Week 6 > Clinical: Syncope > Flashcards

Flashcards in Clinical: Syncope Deck (35):

What age groups have a high incidence of syncope?

  • 10 to 30 year-olds
  • Incidence also increases after age 70


  • What must occur to the brain for a patient to have syncope?


Describe the criteria for BP levels for syncope


Neurally Mediated [Reflex] Syncope

  • All the disorders in this group have a common final pathway characterized by what 3 conditions? 


Neurally Mediated [Reflex] Syncope

  • What happens to parasympathetic tone?
  • What "reflex" is involved?
  • What kind of vessel control is involved?
  • How worried are most doctors about this form of syncope?


These strips are from a patient who was induced to have a fainting episode

  • What is a "jerk" associated with?
  • Where is the vasovagal response occurring?
  • What is the asystole associated with?

  • Jerk
    • Syncope + not being able to lay horizontally when passed out
  • Vasovagal = Red
  • Asystole (Blue)
    • Drop in blood pressure


Neurally Mediated [Reflex] Syncope: Vasovagal Syncope

  • What is notable about this type of syncope in term of incidence?
  • What 2 conditions is it associated with?
  • How deadly is this type of syncope?
  • What are some of the prodromal symptoms associated with it?


Carotid Sinus Hypersensitivity

  • What type of syncope does this fall under?
  • What is the cause of this physiological cause of this condition?
  • What activities can bring about an episode of this type of syncope? 


  • What category of syncope do these all fall under?
  • Do we consider them risky or mostly benign?



  • What type of syncope is associated with a drop in systolic BP?
  • What population usually has this type, and why?
  • What medications can produce this syncope, and what type of conditions can produce it?


Orthostatic Hypotension

  • What are the BP criteria for this type of syncope?
  • How do you test for it?


Cardiac Syncope

  • What are the main categories of cardiac syncope?
    • What conditions make up the "other" category?
  • Why do we consider these forms on syncope serious/risky?

  1. Arrhythmias
  2. Structural/Valve Disease
  3. "Other" 


What type of syncope are is the following associated with?

Cardiac Syncope: Bradyarrhythmias 


What is a Stokes-Adams Attack?

Syncope due to a heart block


What makes you believe that this patient suffered a Stokes-Adams attack?

The heart block lasts between 2 and 2.5 seconds, which can lead to syncope


Which type of syncope is the following associated with?

Cardiac Syncope: Bradyarrhythmias 


Which type of syncope is the following associated with?

How do you treat it?

Cardiac Syncope: Bradyarrhythmias 


Cardiac Syncope: Tachyarrhythmias

  • What criteria for heart rate can cause this form of syncope?
  • How is this syncope related to
    • Diastole
    • Blood Pressure
    • Blood Perfusion
  • What general type of cardiac disease is this common in?


Cardiac Syncope: Tachyarrhythmias

  • What type of heart rhythm is most concerning?


Cardiac Syncope: Tachyarrhythmias

  • What conditions/disease put PTs at high risk of ventricular arrhythmia?
    • Which condition is associated with sudden death particularly in Asian males?


Cardiac Syncope: Tachyarrhythmias and Ischemic Heart Disease

  • How often do MI patients present with syncope as a major symptom?
  • Why would a patient with a previous MI present with a ventricular arrhythmia?


Cardiac Syncope: Tachyarrhythmias and Prolonged QT [Hereditary]

  • What is the general mechanism behind this?
  • What type of rhythm can this develop into?
  • Describe Jervell and Lange-Nielsen syndrome
  • Describe Romano-Ward syndrome


Cardiac Syncope: Tachyarrhythmias and Prolonged QT [Non-Hereditary]

  • What could cause this type of syncope?


Cardiac Syncope: Tachyarrhythmias

  • What type of condition is associated with a bypass tract and an increased risk to develop A-Fib?


Cardiac Syncope: Tachyarrhythmias and Wolff Parkinson White

  • What electrophysical pathology is this associated with?
  • What type of heart condition can patients develop, and what does this present in terms of heart rate?
  • What kind molecules are increased in this condition, and what are the conditions associated with this increase?


Cardiac Syncope: Tachyarrhythmias and Hypertrophic Cardiomyopathy

  • Why is this condition significant in terms of death and young people?
  • What kind of genetic inheritance is this condition associated with? What sex gets this condition at lower rates?
  • Pathology
    • What are the hallmarks of this condition?
    • What structure is most commonly involved?
    • What happens to the outflow from the LV?
  • What to most patients have trouble with and why?


Cardiac Syncope: Tachyarrhythmias and Hypertrophic Cardiomyopathy

  • What would you see on an ECG?
  • Where can a murmur be heard, and is this murmur diastolic or systolic?
  • What do you see when looking at MRI and Ultrasound imaging for this?


Cardiac Syncope: Tachyarrhythmias and Hypertrophic Cardiomyopathy

  • When do these patients get syncope? How does this relate to cardiac output?
  • Why do these patients have angina, and what does this increase the risk for?


Cardiac Syncope: Tachyarrhythmias and Hypertrophic Cardiomyopathy

  • Treatment
    • What are the typical treatments for these patients?
    • What therapy is considered for high-risk patients?


Cardiac Syncope: Aortic Stenosis

  • How often does severe aortic stenosis present with syncope?
  • What happens to cardiac output?
  • How do A-Fib and V-Fib relate to this?


Cardiac Syncope: Heart Failure

  • Relate Syncope due to heart failure to ejection fraction
  • What type of dysrhythmias do these have patients have increased risk for? 
  • What is considered the treatment for this?


Evaluation of Syncope

  • When you have a Pt with syncope, what do you consider/need to do when assessing why they have syncope?


List some of the criteria that would make a patient a high risk syncope patient 


  • Name some of the additional testings you would do on the patient once you receive their ECG