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Wednesday, February 16, 2011

A Simple Guide to Syncope

A Simple guide to Syncope
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What is Syncope?
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Syncope is a temporary loss of consciousness resulting from inadequate cerebral blood supply.

Causes:
A.Vasomotor:
1.Vagal slowing of heart and reduction of blood pressure from fear, severe pain or psychogenic disturbance

2.Hemorrhage or circulatory fluid loss from burns

3.Postural hypotension  - blood pressure drops from sleeping or sitting position to upright position

4.Vasoactive drugs such as anti-hypertensive (prazosin, methyl dopa) and heart medicines(nitites, adrenergic blockers)

5.Carotid sinus compression

B.Cardiac:
1.Asystole or heart blockage

2.Sudden arrhythmias with high ventricular rate

3.Heart valve prosthesis

4.Aortic stenosis with exertion

5.Cardiogenic shock following myocardial infarction

6.Sudden cardiac compression

What are the Signs and Symptoms of Syncope
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A.Vasomotor:
Symptoms:
1.cold sweats, pallor, yawning,

2.Urge to urinate or defecate

3.low blood pressure

4.dilated pupils

5.Drug therapy such as adrenagenic blockers

B.Cardiac:
1.ECG evidence of arrhythmia, heart block, asystile, or myocardial infarction

2.history of valve prosthesis, aortic stenosis or chest injury

What are the complications of Syncope?
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The complications are:
1.head injury

2.fractures

What is the Treatment of Syncope?
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1. Patients with postural or psychogenic syncope recover in recumbent position

2.Cardiac syncope from myocardial infarction needs the patient to be hospitalized and managed in cardiac care unit

3. heart blocks or asystole may need pacemaker implantation

4.Tachycardia with arrhythmia must be treated with special medicies to slow the heart

5.review drug therapy abd dosage of potentially causative medicines such as adrenergenic blocking drugs, beta blockers or vasodilators such as nitrates



Prognosis:
1.depends on cause -vasomotor are less serious than cardiac.

2.it may present as a life threatening condition requiring immediate treatment in cardiac syncope

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