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syncope [2026/06/24 03:45] – [syncope / near syncope] gary1syncope [2026/06/24 05:08] (current) – gary1
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   *in the elderly they are particularly concerning, not only because of the higher incidence of potentially life threatening causes but also in the high morbidity and mortality associated with falls such as [[nof]], [[head_injury_adult]], [[fracture_ribs]], etc, not to mention the significant subsequent loss of confidence walking.   *in the elderly they are particularly concerning, not only because of the higher incidence of potentially life threatening causes but also in the high morbidity and mortality associated with falls such as [[nof]], [[head_injury_adult]], [[fracture_ribs]], etc, not to mention the significant subsequent loss of confidence walking.
   *while many are due to benign conditions (especially in the younger population) such as vasovagal events and  cough/micturition syncope there are a wide range of not so benign conditions that need to be considered including:   *while many are due to benign conditions (especially in the younger population) such as vasovagal events and  cough/micturition syncope there are a wide range of not so benign conditions that need to be considered including:
-    *[[shock]] or postural hypotension+    *[[shock]] or [[hypotension_postural]]
       *[[sepsis]]       *[[sepsis]]
       *acute blood loss (eg. [[gitbleeding_upper]], [[ectopic_pregnancy]], both of which may initially be occult)       *acute blood loss (eg. [[gitbleeding_upper]], [[ectopic_pregnancy]], both of which may initially be occult)
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           * [[shortqtc]]           * [[shortqtc]]
     *[[SAH]]     *[[SAH]]
-    *postural hypotension+    *[[hypotension_postural]]
   ***persistent decreased cognitive function following the collapse suggests:**   ***persistent decreased cognitive function following the collapse suggests:**
     *ongoing hypotension     *ongoing hypotension
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       * Carotid sinus massage should be considered in both supine and upright positions whilst cardac monitored as patients with this cause develop 5-10 secs of asystole with often delayed return of BP. These patients do well with cardiac pacemaker.       * Carotid sinus massage should be considered in both supine and upright positions whilst cardac monitored as patients with this cause develop 5-10 secs of asystole with often delayed return of BP. These patients do well with cardiac pacemaker.
     * Cardiac arrhythmias     * Cardiac arrhythmias
-    * orthostatic hypotension due to medications, dehydration (which most elderly have), and [[n_dysautonomia|age or disease related impaired autonomic systems such autonomic neuropathy and post-prandial hypotension]]+    * [[hypotension_postural]] due to medications, dehydration (which most elderly have), and [[n_dysautonomia|age or disease related impaired autonomic systems such autonomic neuropathy and post-prandial hypotension]]
  
 =====Mx of the child / adolescent with syncope===== =====Mx of the child / adolescent with syncope=====
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     *[[hocm]] - LVH +/- narrow & deep Q waves in the lateral leads duration of < 40 ms     *[[hocm]] - LVH +/- narrow & deep Q waves in the lateral leads duration of < 40 ms
     *[[ARVD|Arrythmogenic Right Ventricular Dysplasia (ARVD)]] - T inv V1-3, epsilon wave, wide S     *[[ARVD|Arrythmogenic Right Ventricular Dysplasia (ARVD)]] - T inv V1-3, epsilon wave, wide S
 +
 =====Mx of the older adult with syncope===== =====Mx of the older adult with syncope=====
   *history, medication history (is the patient on anticoagulants, etc), and examination (is there evidence of acute stroke?) to ascertain potential cause and exclude any injuries due to a fall   *history, medication history (is the patient on anticoagulants, etc), and examination (is there evidence of acute stroke?) to ascertain potential cause and exclude any injuries due to a fall
syncope.txt · Last modified: 2026/06/24 05:08 by gary1
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