A Practical Approach to Syncope

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Posture and situation cont.• Emotional stress, fear, blood.– VVS• After exercise– Some arrhythmias (VT, SVT)• Warm, crowded places– VVS• Sudden change in posture– Au<strong>to</strong>nomic failure– Carotid sinus syncope
• Case Hx 2• 62 yr old man• Rx in ICU for renal impairment andpneumonia• Short episode of syncope withdocumented asys<strong>to</strong>le• R Carotid massage at bedside showedlong sinus pause
Page 1 and 2: A Practical Approach to SyncopeDr.
Page 3 and 4: Exclusions• Conditions with LOC b
Page 6 and 7: Pre-syncope ↔ Syncope?
Page 8 and 9: Hx of syncope episodeLatest episode
Page 10 and 11: • Time of episode- Early morning
Page 14 and 15: Preceding symptoms• Palpitations-
Page 16 and 17: During syncope• Tonic clonic move
Page 18 and 19: Recovery• Spontaneous and complet
Page 20 and 21: VVSStructural HDAutonomic failureDr
Page 22 and 23: Case Hx 5Episode of Syncopeyoung•
Page 24 and 25: After Hx & ExDefinite Syncope• Ve
Page 26 and 27: InvestigationsEchocardiogram• AS/
Page 28 and 29: InvestigationsTruesyncopeAppropriat
Page 31 and 32: Carotid massage
Page 35 and 36: Bradycardiastudy
Page 39 and 40: High Risk Patients who may need adm
Page 41: Case Hx 6• 68 year old women• H

A Practical Approach to Syncope

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