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Transient Loss of Conscious (Central (Compression of brain-stem (raised…
Transient Loss of Conscious
Central
Compression of brain-stem (raised ICP)
Hemorrhage
SOL
Hydrocephalus
Electro-distrubance
Seizure
Electrolyte distrubance
Alcohol Intoxication
Peripheral
Reduced in Quantity of blood to brain
Hypovolemic (Orthostatic Syncope)
SIRS/Sepsis
Dehydration
Hemorrhage
Autonomic Failure
Primary: Multisystem atrophy, parkinson
Secondary: Uremia, Vit B12 def, DM
Cardiogenic syncope
Arrhythmia
Stokes-Adam attack
Reduced in EF
Structural Heart disease:
MI, AS, HOCM. Dissection, Congenital ToF
Error in feedback mechanism (reflex syncope)
Carotid sinus syndrome
Vasovagal syncope:
Stimulus (emotion, pain, fear and prolonged standing) inducing a reduction of HR and BP
Situational Syncope:
Specific stimuli - Exertion, Cough or micturition
"reproducible form of vasovagal"
Subclavian steal syndrome
Reduced in Quality of blood to brain
Hypoxia
Hypoglycemia
For Syncope history, Ask:
Pre syncope (Differentiate from seizure, identify triggers)
During syncope (TRO seizure - tongue-biting, jerking of limbs, eyes up-rolling. Duration of episode?)
Post syncope (TRO seizure - confusion, lethargy)
Unique points:
Surrogate interview is crucial, check with SCDF/Ambulance/First-aid crew/family and friends