1 / 17

SYNCOPE

SYNCOPE. Constantino G, Perego F et al: Short- and long-term prognosis of syncope, risk factors, and role of hospital admission: results from the STePS (Short-Term Prognosis of Syncope) study. J Am Coll Cardiol. 2008 Jan 22; 51(3):284-7. INCIDENCE OF SYNCOPE IN FRAMINGHAM STUDY.

brit
Télécharger la présentation

SYNCOPE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. SYNCOPE

  2. Constantino G, Perego F et al: Short- and long-term prognosis of syncope, risk factors, and role of hospital admission: results from the STePS (Short-Term Prognosis of Syncope) study. J Am Coll Cardiol. 2008 Jan 22; 51(3):284-7.

  3. INCIDENCE OF SYNCOPE IN FRAMINGHAM STUDY

  4. Anxiety/Depression Affects daily living Limits driving abilities Change work

  5. ETIOLOGY • Age-induced syncope • Cardiac syncope • Reflex-induced syncope • Orthostatic hypotension • Neurological syncope • Idiopathic syncope

  6. AGE-INDUCED SYNCOPE • AGE-INDUCED MODIFICATIONS OF: • Vascular system • Cardiac system • Autonomous nervous system • Non-cardiac modifications

  7. VASCULAR SYSTEM • Ats  blood vessels become rigid • Decrease NO release • Increment of endothelin release

  8. CARDIAC SYSTEM •  post-load (vascular rigidization) • Hypodiastolic HF (fibrosis of myocardium muscle) • Hyposistolic HF (hypertension, ischemia) • Degeneration of valvular system (calcification) • Decrease function of pace-maker  increase arrhythmias (AF, SSS) and AV blocks

  9. NON-CARDIO FACTORS • HYPOVOLEMIA • Dehydration • Drugs (diuretics) • Sedentary life • Poor fluid intake

  10. REFLEX-MEDIATED SYNCOPE • defecation, urination, sneezing, coughing, big meals, shifting position too quickly • Vagal reflex Hypotension

  11. CAROTIDIAN SYNUS SYNDROME • Exaggerated sensitivity to normal pressure • 20% of cases of syncope • Frequent causes: movements of the head, tie too tight, shaving the neck • Stimulation of baroreceptors from carotidian synus • Bradycardia + vasodilation • Asystola > 3 s +  systolic BP with > 50mmHg

  12. POSTPRANDIALĂ HYPOTENSION Decrease of systolic BP with ≥ 20 mmHg in the first 90 minutes after a big meal

  13. CEREBROVASCULAR, NEUROLOGICAL AND PSYCHIATRIC CAUSES • Ischemia in posterior cerebral arteries teritory • Subclavicular stenosis  syncope when rising the hands • Subarahnoidian hemorrhage • Seizures • Hysteria • Panic/anxiety attack

  14. OTHER CAUSES • Polimedication • Alcohol • Severe anemia • Fever

  15. LIFE-THREATENING CAUSES • MI • Acute pericarditis - tamponade • Dissecting aneurysm • Pneumothorax • Internal bleeding • Severe cardiac arrhythmia

  16. Anamneza Examenul fizic ECG Ecocardiografie Boala cardiacă Aritmie DA NU • Explorări cardiace suplimentare • Proba de efort • ABPM • Studii electrofiziologice Testarea sistemului autonom: Manevra Valsalva Tilt-test Negativ Negativ Negativ Ia în considerare alte cauze: Neurologice Psihiatrice Testarea sistemului autonom: Manevra Valsalva Tilt-test

More Related