Syncope

Question 1

Define syncope

Answer 1

clinical syndrome with transient loss of consciousness secondary to inadequate cerebral nutrient flow

Question 2

Define pre-near syncope

Answer 2

lightheadedness, feeling unstable, dizzy, nausea, feeling hot or cold

Question 3

How to determine of someone experienced true syncope

Answer 3

• frequency or duration of episodes
• position before the episode
• witnessed signs or provoking factors
• pre-existing conditions

Question 4

What are some diagnostic tests that could be used in the case of syncope

Answer 4

-ECG
-transthoracic echo
-neuro test
-stress test
-carotid massage
-tilt test

Question 5

Management of syncope

Answer 5

-based on underlying cause to prevent injury/death from recurrent episodes
-state based driving restrictions

Question 6

What position is someone usually in before reflex syncope

Answer 6

upright

Question 7

What position is someone usually in before orthostatic syncope

Answer 7

changing positions

Question 8

What position is someone usually in before syncope related to cardiac arrhythmia

Answer 8

supine

Question 9

Define reflex syncope

Answer 9

neurally mediated, mixed hemodynamic response
- vasovagal, situational, carotid sinus syndrome
- absence of heart dz

Question 10

Define vasovagal syncope

Answer 10

syncope in response to emotion/pain, unknown trigger, usually some warning symptoms
- efferent vasodepressor reflexes resulting in decreased peripheral vascular resistance

Question 11

Describe the symptoms of vasovagal syncope

Answer 11

nausea, diaphoresis, graying out of vision, normal BP response to standing

Question 12

Define situational syncope

Answer 12

syncope in response to a situation such as micturition, defecation, swallowing, coughing/sneezing, eating

Question 13

Define carotid sinus syndrome

Answer 13

syncope following abrupt neck movement or stimulation of the carotid

Question 14

What are some cardiovascular causes of reflex syncope

Answer 14

tachy/brady arrythmias, structural diseases, cardiopulmonary/vascular causes

Question 15

Define orthostatic syncope

Answer 15

syncope following change in position
-can be med related or secondary to volume depletion or autonomic failure

Question 16

What can you treat orthostatic syncope with

Answer 16

• treat underlying condition
• fludrocortisone

Question 17

Describe pediatric syncope

Answer 17

• usually benign alterations in vasomotor tone
• can be life threatening if secondary to cardiac etiology

Question 18

What is the most common cause of syncope in peds

Answer 18

vasovagal syncope, secondary to breath holding spells (triggered by emotion)

Question 19

Describe POTS (postural tachycardia syndrome)

Answer 19

excessive increase in HR with standing, no arterial hypertension
- palpations, anxiety, dizziness, tremulousness