Guidelines for the diagnosis and management of syncope subject version 2009 description. Pdf epidemiology, pathophysiology and treatment of different. Syncope is a broad medical term used for fainting or loss of consciousness due to a temporary decline in blood flow to the brain. The workup of syncope includes a careful history, physical examination. The causes of fainting may range from mild to severe conditions. The pathophysiology of common causes of syncope w arthur, g c kaye syncope is a transient loss of consciousness secondary to inadequate cerebral perfusion with oxygenated blood. Blood vessels continually adjust their width to ensure a constant blood pressure. Check out this lesson to learn more about what causes syncope, how it can vary, and some of its common symptoms. Fainting tends to be preceded first by paleness, nausea, and. There can be a number of causes of syncope, but the main four groups are as followed. History is very important for distinguishing syncope from other causes seizure, dizziness, vertigo, presyncope. It is caused by a sudden drop in blood pressure, which causes a drop in blood flow to the brain. Its also called reflex, neurocardiogenic, vasovagal vvs or vasodepressor syncope. Syncope is classified as neurally mediated, cardiac, and orthostatic hypotension.
Syncope may be associated with a sudden fall in blood pressure, a decrease in heart rate or changes in blood volume or distribution. Syncope fainting information sheet fact sheet sunshine coast. Approximately 1030% of the syncope episodes in patients above 60 years visiting a hospital for their syncope episodes are of cardiac origin. Syncope definition, causes, history taking geeky medics.
Although most causes of syncope are benign and require no. Psychogenic pseudosyncope pps is the appearance of transient loss of consciousness tloc in the absence of true loss of consciousness. Fainting is due to a sudden decrease in blood flow and oxygen to the brain. It is done with intermittent measurement of blood pressure using a manual sphygmomanometer in a supine position and 3. Syncope fainting information sheet queensland health. History taking is the most important feature in syncope evaluation.
It results from arrhythmias, mechanical abnor malities, or structural abnormalities, and is generally seen in older adults. There are many causes of syncope, but most fall into 1 of 3 major types. Syncope is a common and challenging presentation for the emergency physician. Syncope pronounced sin ko pea is the medical term for fainting or passing out. While seemingly straightforward, the fact that it is often a heavily historyfocused diagnosis means that it is an important topic to know about.
Syncope accompanied by injury during the episode increases the likelihood of a cardiac cause or seizure somewhat, and therefore the event is of greater concern. For example, cough syncope, micturition syncope, and swallow syncope are examples in emergency evaluation of syncope in children and adolescents view in chinese isolated syncope but may be useful in syncopal pediatric patients with palpitations, frequent syncopal episodes, or exertional syncope. The word clonic is in everyday use restricted to epilepsy, while the word myoclonus is used for the movements in syncope as well as for certain types of epilepsy and to describe postanoxic. Syncope is the medical term used for blacking out or fainting. Patient suspected to have a cause of tloc other than syncope ie seizure syncope due to a neurological disorder causing autonomic nervous failure carotid us, ct or mri imaging of the brain, eeg are not indicated for workup of tloc thought to be due to syncope tia is a rare cause of tloc, and it will be. Syncope is a loss of consciousness that happens due to a decrease in blood flow to your brain. Syncope often is due to a benign process but can be an indication of serious underlying disease in both the adult and pediatric patient. Syncope is a sudden and transient loss of consciousness with loss of postural tone from which recovery is spontaneous and complete. Syncope is thus triggered by a metrical lapse of unstressed vowels. A report of the american college of cardiologyamerican heart association task force on clinical practice guidelines, and the heart rhythm society.
Syncope in patient exposed to high risk settings recurrent episodes of syncope without organic heart disease recurrent episodes of syncope with organic heart disease and cardiac etiology of syncope has been ruled out moya et al. The frequency of orthostatic hypotension and cardiac syncope increases with age. There are a number of disorders which present similarly and a. Several studies have shown a normal longterm survival rate in patients with syncope who have no structural heart disease, which is the most important predictor of death and ventricular arrhythmia. In young patients, ho recurrent syncope is associated with an increased risk of sudden death. Gauer, md, womack army medical center, fort bragg, north carolina s yncope is a transient and abrupt loss of consciousness with complete. Syncope in pediatrics university of vermont health network.
Syncope, commonly known as fainting or passing out, is a symptom which presents frequently in the emergency department. Nms is more common in children and young adults, though it can occur at any age. In addition, short stressed vowels cannot occur in an open syllable in english stresstoweight, except when preceding a. Syncope and driving a vehicle those who drive and have recurrent syncope risk their lives and the lives of others places considerable burden on the physician essential to know local laws and physician responsibilities some states invasion of privacy to notify motor vehicle department other states reporting. Pdf syncope is a transient loss of consciousness secondary to inadequate cerebral perfusion with oxygenated blood. This article focuses on the general overview of different types of syncope which includes common causes, epidemiology, pathophysiology, symptoms, signs and. The warning signs and slower loc that accompany benign vasovagal syncope somewhat reduce the likelihood of injury. Sep 01, 2008 syncope is a sudden transient loss of consciousness and postural tone with spontaneous recovery. Vasovagal syncope vvs, the most common type of syncope, should be assumed once other causes are excluded. Syncope typically occurs in younger patients with smaller ventricles. It is caused by a decrease in blood flow to the brain, typically from low blood pressure. Loss of consciousness results from a reduction of blood flow to the reticular activating system located in the brain stem. Jan 04, 20 other, nonseizure causes warranting evaluation include cardiogenic syncope particularly given the evidence of ectopic beats on examination and electrocardiogram.
Summary of syncopal disorders dysautonomia international. Neurally mediated syncope is the most common type and has a benign course, whereas cardiac syncope is associated with increased morbidity and mortality. Syncope is a common medical problem, with a frequency between 15% and 39%. In general patients experiencing syncope require cardiac monitoring and emergency department evaluation. On standing, 300 to 800 ml of blood shift from the thorax to the lower extremities. It is caused by a temporary drop in the amount of blood that flows to the brain.
Some forms of syncope are fairly benign, while other forms can indicate serious health problems. Syncope is the formal medical term for fainting, describing a temporary loss of consciousness due to a sudden decline in blood flow to the brain. When you stand up, gravity causes blood to settle in the lower part of your body, below your diaphragm. Dec 08, 2014 syncope is a common medical problem, with a frequency between 15% and 39%. Syncope clinical quick talks society of hospital medicine. Syncope, effect of temporary impairment of blood circulation to a part of the body. Evaluation of syncope in the emergency department micturition, defecation, shaving, or standing for a prolonged period at the time increases the likelihood of a benign cause of syncope. In music, syncopation involves a variety of rhythms played together to make a piece of music, making part or all of a tune or piece of music offbeat. Pdf the pathophysiology of common causes of syncope. Vasovagal syncope is the most common type of syncope. The term is most often used as a synonym for fainting, which is caused by insufficient blood flow to the brain as a result of a fall in blood pressure.
More simply, syncopation is a disturbance or interruption of the regular flow of rhythm. Neurally mediated syncope nms is the most common form of fainting and a frequent reason for emergency department visits. Syncope can happen if you have a sudden drop in blood pressure, a drop in heart rate, or changes in the amount of blood in areas of your body. Nebraska medical center syncope transient loss of consciousness altered blood flow to the brain postural collapse quality quantity european society of cardiology. Syncope is an important clinical problem which accounts for 1% of hospital. If you have symptoms of dizziness or lightheadedness, without loss of consciousness, this is often called presyncope or near syncope, but these symptoms may also be due to conditions that are unrelated to syncope. A fundamental understanding of the various types of syncope along. Guidelines for the diagnosis and management of syncope. Syncope, commonly known as fainting, refers to a sudden loss of consciousness, followed by a rapid and complete recovery.
Summary of syncopal disorders syncope is the formal medical term for fainting, describing a temporary loss of consciousness due to a sudden decline in blood flow to the brain. It is estimated that 1% to 3% of visits to the ed and 6% of hospital admissions are related to syncope. Although most commonly benign, it may herald a pathology with a poor prognosis. Most causes of syncope can be broadly categorized into. Cardiac syncope is the second most common type of syncope.
Syncope is the brief loss of consciousness and posture caused by a temporary decrease in blood flow to the brain. A 66yearold male is brought to the ed from a restaurant where he fainted while dining out with his family. Cardiac causes of syncope often are unpro voked and are more likely to present in the emergency department. Syncope fainting information sheet what is syncope. The term syncope is sometimes used more broadly to refer to any vowel or consonant sound thats commonly omitted in the pronunciation of a word. In the general population, the annual number episodes are 18. It is a common medical problem, accounting for around 5% of acute medical admissions and 3% of emergency department visits.
Sep 15, 2011 syncope is a transient and abrupt loss of consciousness with complete return to preexisting neurologic function. It is a very common presentation to ed and has a huge list of differentials. Psychiatrically, most cases are classified as conversion disorder, which is hypothesized to represent the physical manifestation of internal stressors. Syncope, also known as fainting, is a loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery. Fainting, or syncope, is a brief loss of consciousness when blood flow to the brain suddenly drops. A prodrome, consisting of nausea and vomiting, warmth, diaphoresis, and pallor, often precedes neurocardiogenic syncope. Fainting, medically known as syncope, is a condition that may need immediate medical attention.
489 387 1159 751 125 676 440 1375 777 1183 495 1588 1432 564 770 822 915 116 1106 1464 219 999 133 72 1426 1184 1355 363 492 208 1172 342 216 1415