Term
|
Definition
sudden, transient loss of consciousness due to:
- decrease in perfusion of the brain (O2 depletion)
- Decrease in substrate delivery (Glu)
Huge list of DDX |
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Term
| Clinical signs that may occur with both Syncope and Seizure |
|
Definition
-twitching and stifeening
-Urination
-Defecation
- Vocalization |
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Term
| Clinical signs that occur only with syncope |
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Definition
- Short-lived eent
- Recover very quickly
- P usially has a heart murmyr or Hx of heart dz.
- Usually a precipitating even triggers it |
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Term
| Clinical signs that occur only with seizures |
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Definition
- has distinct phses (pre-ichtal, post-ichtal, tonic-clonic mvts)
- facial twitching
- Nerulogic deficits may be notes |
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Term
|
Definition
reduced brain perfusion or substrate delivery
Not severe enough to cause loss of consciousness
May appear "wobbly"/weak |
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Term
|
Definition
- Cardiovascular
- Non-cardiac
- Reflex |
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Term
| Cardiovascular causes of Syncope |
|
Definition
- Arrythmias
- Complete Heart Block
- Sick siuns Syndrome
- Impaired Forward Output
- Impaired Filling
- Outflow tract obstruction
- Cyanotic Heart DZ |
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Term
|
Definition
| VT, SVT, AFfib, AV block, SICK SINUS SYNDROME) |
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Term
| How is syncope caused by a Complete Heart Block? |
|
Definition
| heart is too slow, so blood in not reaching brain fast enough |
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Term
| How is syncope caused by Sick Sinus Syndrome? |
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Definition
| - the pauses in the rhythms become too long for the blood to reach the brain |
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Term
| How does impaired forward output cause Syncope? |
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Definition
| Dialated Cardiomyaopathy, Mitral Regurgitation |
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Term
| How does Impaired Filling cause Syncope? |
|
Definition
HCM
RCM,
Cardiac Temponade
Common in CATS |
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Term
| How does outflow tract obstruction cause Syncope? |
|
Definition
- Subaortic Stenosis (SAS)
- Pulmonary Stenosis (PS)
- Hypertrophic Cardiomyopathy (HTCM)
- Pulmonary Hypertensions (PHT) |
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Term
| How does syanotic heart disease cause syncope? |
|
Definition
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Term
| Non-Cardiac Causes of Syncope |
|
Definition
- Neurologiv (TE, Cerebrovascular, Brain tumor, Narcolepsy)
- Metabolic (Anemia, Lypoglycemia, Hypoxia)
-Reflex |
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Term
| What REFLEX cause of Non-Cardiogenic Syncope do we know? |
|
Definition
- Neurocardiogenic/Vasovagal
- Situational (Coughing, Micturition, Defecation)
- Carotid Sinus Hypersensitivity |
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Term
| What HX do we need to know to determine Syncope vs. Seisure? |
|
Definition
PE most imporatant
CV Sights: arrhythmia, gallop, murmur, signs of CHF
MM pallor
- Determine reason for collapse episode |
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Term
| Collect this info. to evaluate collapse episode in a logarithm? |
|
Definition
- Get complete description of event
Perofrm PE (CV and Neuro)
- Obtain bloodwork
- If blood work is normallook at muscle weakness (Y/N)
- If abnormal blood work persue the abnormality |
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Term
| What abnormalities may show up in a p with episode of collapse? |
|
Definition
- Anemia
- Hemorrhage
- Hypoglycemia
- Hypoxemia
- Electrolyte imbalance |
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Term
| Diagnostic Approach to Syncope? |
|
Definition
ECG (often misses stransient arrhythmias)
Echo - ID underlying cardiac disease
Thoracic Rads
CBC, Chem, UA
Arterial Blood Gas or Pulse Oximetry
Blood Pressure
ABD US
Ambulatory ECG monitoring |
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Term
| Ambulatory ECG Monitoring |
|
Definition
- Transient Nature of Arrhythmias
- In Hospital Monitoring
- Day-to-Day Variability - 85% |
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Term
|
Definition
- for more transient arrhythmias, SSS, Vasovagal Syndrome
- Can set an Autotrigger to record several min before and after the desired HR or ECG abnormality
- Can set up Patient trigger |
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Term
|
Definition
| No underlying heart disease |
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