Syncope
Syncope is a "transient loss of consciousness and postural tone caused by diminished blood flow to the brain (i.e., brain ischemia). Presyncope refers to the sensation of lightheadedness and loss of strength that precedes a syncopal event or accompanies an incomplete syncope."[1]
Diagnosis
History and physical
An evaluation based on the initial history and physical examination will correctly diagnose the underlying cause in 63% of patients according to one case series.[2]
Having more than one prodrome symptom (e.g. dizzines, nausea) is predictive of vasovagal and psychogenic syncope.[3]
Regarding the physical exam, testing or carotid sinus hypersensitivity may be best done with the patients standing.[4]
Testing
A p-wave longer than 120 ms on electrocardiogram is suggestive of a cardiac arrhythmia.[3]
References
- ↑ Anonymous (2024), Syncope (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ van Dijk N, Boer KR, Colman N, et al (2008). "High diagnostic yield and accuracy of history, physical examination, and ECG in patients with transient loss of consciousness in FAST: the Fainting Assessment study". J. Cardiovasc. Electrophysiol. 19 (1): 48–55. DOI:10.1111/j.1540-8167.2007.00984.x. PMID 17916139. Research Blogging.
- ↑ 3.0 3.1 Graf D, Schlaepfer J, Gollut E, et al (2008). "Predictive models of syncope causes in an outpatient clinic". Int. J. Cardiol. 123 (3): 249–56. DOI:10.1016/j.ijcard.2006.12.007. PMID 17397948. Research Blogging.
- ↑ Parry SW, Richardson DA, O'Shea D, Sen B, Kenny RA (2000). "Diagnosis of carotid sinus hypersensitivity in older adults: carotid sinus massage in the upright position is essential". Heart 83 (1): 22–3. PMID 10618329. [e]