Definition
of Syncope
It is the sudden transient loss of
consciousness and the patient is unable to maintain upright posture. It is due
to impaired cerebral blood flow.
Causes
of syncope
1. Simple
syncope otherwise called vasovagal
syncope occur due to vasovagal phenomenon. They are associated with unpleasant sight, cough
syncope micturition syncope, carotid sinus syncope and acute severe pain.
2. Cardiovascular
syncope
Occur in cardiovascular
disorders, common disorders associated are
-
Complete heart block
-
Sick sinus syndrome
-
Brady or tachyarrhythmia
-
Prolonged QT interval
-
Aortic stenosis
-
Eisenmenger syndrome
-
Hypertensive carotid sinus
syncope
-
Acute pulmonary embolism.
3. Postural
hypotension is a cause of syncope occur in patients receiving drugs such as
antihypertensives and vasodilators. Eg. are methyldopa, Prazoin and Diuretics
4. Metabolic
causes of syncope are hypoglycemia and alcohol intoxication.
5. Neurological
causes of syncope are verebro baaclar insufficiency familial dysautonomic.
6. Unknown
causes.
Following are the causes of
syncope with episodic fainting.
1.
Hyperventilation syndrome
2.
Transient ischemic attack
|
3. Severe
anemia
4. Hypoglycaemia
5. Acute
blood loss
|
Important history to be
taken in a patient with syncopal attack are
1. Duration of attack
2. Associated
with exertion – Exertional syncope is seen with aortic stenosis.
3. Convulsion
present or absent
4. History
of repeated attack
5. Preceding
symptoms such as light headedness