1 / 10

Syncope

Syncope J. Ned Pruitt II, MD Associate Professor of Neurology Medical College of Georgia Syncope Syncope – a transient loss of consciousness with a loss of postural tone caused by a brief global reduction or cessation of cerebral blood flow

jana
Download Presentation

Syncope

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Syncope J. Ned Pruitt II, MD Associate Professor of Neurology Medical College of Georgia

  2. Syncope • Syncope – a transient loss of consciousness with a loss of postural tone caused by a brief global reduction or cessation of cerebral blood flow • Causes - cardiac, neurlogic, vascular, and psychiatric

  3. Clinical Manifestations of Syncope • “Dizzyness” or dysequilibrium – visual changes “greying out” - mental clouding – deafness – nausea – loss of postural tone • Rostral to caudal progression • Myoclonus – “jerking” not seizure activity • Rapid recovery of consciousness without a post-ictal confusion or exhaustion • No focal neurologic before or after event

  4. Causes of Syncope • Cardiovascular – • Decreased preload – hypovolemia/hemorrhage, Valsalva manuever • Decreased iontrophy – cardiac ischemia, cardiomyopathy • Dysrhythmia - • Bradycardia - asystole, carotid sinus hypersensitivity, micturtion, defecation • Tachycardia - supraventricular or ventricular

  5. Causes of Syncope • Cardiovascular (cont’d) • Flow obstruction – pulmonary embolism, pulmonary hypertension, aortic stenosis, iodopathic hypertrophic subaortic stenosis, value disease • Tamponade • Anemia

  6. Causes of Syncope • Neurologic • Neurocardiogenic sycope – “the faint” • Vasovagal syncope • Autonomic insufficency • Medications – alpha and beta blockers • Peripheral neuropathy – diabetes, GBS • Adrenal insufficiency • Prolonged bedrest • syrinx

  7. Causes of Syncope Neurologic - (cont’d) • Increased intracranial pressure – SAH, shunt malfunction, obstructive hydrocephalus, venous sinus occlusion • Vertebral artery disease – dissection with embolus, subclavian steal • Hyperventilation

  8. Symptoms of Autonomic Insufficiency • Orthostatic hypotension • “dizzy” with change in position • Dry mouth • Constipation or obstipation • Impotence • Blurred vision

  9. Syncope Workup • History and physical • BP in both arms • BP lying, sitting and standing • ECG, cardiac event monitor or loop recorder • Rarely EEG • MRI and CT of little use if neuro exam is normal

  10. Syncope Treatment • Cardiac – pacemaker, medications if low CO, defibrillator • Removal of offending medications • Treatment of vascular disease • Counciling and recognition – paperbag • Autonomic insufficiency – SSRI, NaCl, midodrine,

More Related