The symptoms and presentation of syncope are similar to many other conditions, which can lead to difficulty in establishing a diagnosis in the ED. [ncbi.nlm.nih.gov]

• Falling

  Often when people fall, they develop a fear of falling, even if they were not injured in the initial fall. [sah.org.au]

  Non accidental falls These patients experience recurrent episodes of non accidental and unexplained falls which occur when there is transinet brain hypoperfusion and loss of consciousness. [medicaljoyworks.com]

  Indeed, the heart rate increases slowly as the arterial pressure falls. [courses.washington.edu]

  ‘Cardiac arrhythmias or syncope clearly associated with a fall should be treated with antiarrhythmics or a pacemaker in consultation with a cardiologist.’ [en.oxforddictionaries.com]

• Anemia

  [G. synkopē, cutting short] syncope a temporary suspension of consciousness due to cerebral anemia; fainting. cardiac syncope sudden loss of consciousness due to cerebral anemia caused by ventricular asystole, extreme bradycardia or ventricular fibrillation [medical-dictionary.thefreedictionary.com]

  The term syncope (or fainting) refers to cerebral anemia. Syncope causes collapse, which may last from seconds to minutes. Most fainting spells are due to low blood pressure or lack of oxygen delivery to the brain. [canine-epilepsy.com]

  Anemia Anemia (low red blood cell count), whether it occurs acutely from bleeding or gradually for a variety of reasons, can cause fainting because there aren't enough red blood cells to deliver oxygen to the brain. [medicinenet.com]

  Low blood pressure, ineffective pumping by the heart because of heart disease (heart failure), or heart valve abnormalities may cause fainting, as can anemia (low red blood cell count), drugs (especially those for high blood pressure), lung diseases, [spectrumhealth.org]

• Pallor

  […] men and during familiarization sessions (in which BFR was applied alone) but not thereafter (BFR sessions combined with NMES): 1 subject experienced a brief syncope and 2 other subjects exhibited presyncopal symptoms (sweating, lightheadedness, and pallor [ncbi.nlm.nih.gov]

  In the second to minutes leading up to the fainting, the patient may feel weakness, nausea, pallor, and sweating. [courses.washington.edu]

  […] at-risk patient Reduce Stress Treat patient in a supine position Ensure profound local anesthesia Use local anesthetic agents containing a vasoconstrictor congruent with the patient’s functional capacity Signs and symptoms: Adrenergic component Anxiety Pallor [dentalcare.com]

  […] troponin >99th percentile of normal population Abnormal QRS axis 100° Vasovagal syncope Based on evaluation and clinical impression in ED (i.e., vasovagal predisposition - unpleasant sight, sound, smell, or pain; prolonged standing; hot crowded place; pallor [mdcalc.com]

• Unconsciousness

  The most common symptoms include: Unconsciousness Dizziness Pallor In some cases, unconsciousness is accompanied by myocloni 4.1 Prodromes Nausea Vomiting abdominal sensation of pressure Chills Sweating Blurred vision Aura A syncope can be followed by [flexikon.doccheck.com]

  In pathology, "failure of the heart's action," hence "unconsciousness." MORE RELATED WORDS FOR SYNCOPE coma noun deep unconsciousness Roget's 21st Century Thesaurus, Third Edition Copyright © 2013 by the Philip Lief Group. [thesaurus.com]

  Usually seconds Usually more than a few seconds, up to minute Incontinence Absent May be present Confusion on waking Absent Marked for 20-30 mins Tonic-clonic movements, presence and timing Occasionally & brief particularly if unconsciousness is prolonged [rch.org.au]

  […] assist an elderly woman who fainted due to the heat while waiting among the large crowds of people.jpg 1 200 × 1 800; 408 KB US Navy 110614-N-XD935-042 Navy Diver 2nd Class Ryan Arnold guides Chief Hospital Corpsman Nathanael Warren, who is acting as an unconscious [commons.wikimedia.org]

  After fainting, an individual may be unconscious for a minute or two, but will revive and slowly return to normal. Syncope can occur in otherwise healthy people and affects all age groups, but occurs more often in the elderly. [ninds.nih.gov]

• Nausea

  Premonitory symptoms, such as nausea, diaphoresis, abdominal discomfort, and blurred vision, are caused by autonomic activation and are distinguishing features of neurally mediated syncope. [ncbi.nlm.nih.gov]

  In the second to minutes leading up to the fainting, the patient may feel weakness, nausea, pallor, and sweating. [courses.washington.edu]

  Important associated symptoms immediately before or after the event include whether there was a sense of impending loss of consciousness, nausea, sweating, blurred or tunnel vision, tingling of lips or fingertips, chest pain, or palpitations. [msdmanuals.com]

• Hypotension

  Syncope suspected of orthostatic hypotension (OH) can be mediated by neurogenic conditions, dehydration, or drugs. [acc.org]

  It is a subset of a broader class of medical conditions, including postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension, and neurally mediated syncope (NMS), that may result in TLOC. [ncbi.nlm.nih.gov]

  Orthostatic Hypotension In orthostatic hypotension (postural hypotension), patients tend to faint on standing. One typical cause is depleted extracellular fluid volume, perhaps due to use of a diuretic. [courses.washington.edu]

• Orthostatic Hypotension

  It is a subset of a broader class of medical conditions, including postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension, and neurally mediated syncope (NMS), that may result in TLOC. [ncbi.nlm.nih.gov]

  In contrast, in patients with orthostatic hypotension due to autonomic failure, these cardiovascular homeostatic reflexes are chronically impaired. [accessmedicine.mhmedical.com]

  hypotension Syncope (fainting), vasovagal Syncope (loss of consciousness, fainting) Syncope and collapse (fainting) Syncope due to orthostatic hypotension Syncope, cough Syncope, micturition Syncope, vasovagal Transient loss of consciousness Tussive [icd9data.com]

  Orthostatic hypotension can also activate the vagal reflex, causing reflex-mediated syncope. [ahajournals.org]

  Orthostatic Hypotension In orthostatic hypotension (postural hypotension), patients tend to faint on standing. One typical cause is depleted extracellular fluid volume, perhaps due to use of a diuretic. [courses.washington.edu]

• Palpitations

  There was no history of fall, syncope, prodrome, dyspnoea, chest discomfort or palpitations. Medical history was notable for hyperlipidaemia and treated hypertension. Blood pressure was 140/90 mm Hg, pulse 85  beats per minute (BPM). [ncbi.nlm.nih.gov]

  Efficacy of implantable loop recorders in establishing symptom-rhythm correlation in young patients with syncope and palpitations. Pediatrics, 112(3), 228-233. Snyder, C., (2010). Refer or reassure: guidance on managing patients with syncope. [pedclerk.bsd.uchicago.edu]

  Red flags for potential cardiac aetiology are: lack of prodrome palpitations or chest pain exercise-induced syncope past cardiac history family history of early cardiac death, arrhythmia or sudden death. [rch.org.au]

• Slow Pulse

  pulse Neurally mediated syncope (vasovagal), cardiac syncope (bradyarrhythmia) Tonic-clonic movement or posture Seizure None Vasovagal or cardiac syncope in older patients, cardiac syncope in younger patients Table 3. [aafp.org]

  Symptoms include deep and fast respiration, weak and slow pulse and respiratory pauses that may last for 60 seconds. [en.wikipedia.org]

• Shoulder Pain

  These conditions can have associated chest pain, neck pain, shoulder pain, dyspnea, epigastric pain, hypotension, alteration of mental status and can result in sudden death. [emedicine.com]

• Cold, Clammy Skin

  clammy skin Skin paleness Slow, weak pulse Jerky, abnormal movements which usually are seen once someone has actually passed out Infrequently, blood pressure can drop enough to cause a reactive seizure These symptoms can be associated with other health [barrowneuro.org]

  Marked pallor in conjunction with cold clammy skin favors neural-reflex syncope (vasovagal or situational syncope). [thecardiologyadvisor.com]

  Physical findings often reported by bystanders (if the physician asks) in these cases include marked pallor, damp and cold (“clammy”) skin, and confusion. [scielo.edu.uy]

• Increased Sweating

  Additionally, wearing heavy equipment (such as football pads or firefighter bunker gear) and a uniform increases sweating, resulting in dehydration. [ksi.uconn.edu]

• Dizziness

  Certain movements can also be done to keep dizziness from leading to fainting. [cincinnatichildrens.org]

  We report a 55-year-old woman with systemic lupus erythematosus, who later developed episodes of syncope and dizziness along with diaphoresis and palpitations. She also had associated abdominal pain and vomiting. [ncbi.nlm.nih.gov]

  […] syncope in a Sentence syncope has been reported in a small percentage of patients taking the drug Recent Examples on the Web According to the Harford County Health Department, heat illness takes many forms, including heat fatigue, heat syncope (sudden dizziness [merriam-webster.com]

  How to Get Rid of Dizziness Getting rid of feeling dizzy depends on what is causing the dizziness, some treatments to get rid of dizziness include: Home remedies can relieve nausea and vomiting, for example, ginger tea. [medicinenet.com]

• Confusion

  The overlap of these clinical conditions leads to confusion regarding syncope classification that can hinder evaluation strategies, and pose challenges for diagnosis and treatment, particularly in young women. [ncbi.nlm.nih.gov]

  On the other hand, seizures are easily confused with syncope and remain in the differential diagnosis of the patient who appears to have had syncope (see Figure 31-1). [accessmedicine.mhmedical.com]

  The most common symptoms include: Unconsciousness Dizziness Pallor In some cases, unconsciousness is accompanied by myocloni 4.1 Prodromes Nausea Vomiting abdominal sensation of pressure Chills Sweating Blurred vision Aura A syncope can be followed by confusion [flexikon.doccheck.com]

  […] consciousness breathing pattern (snoring) movements (tonic, clonic, tonic-clonic or minimal myoclonus, automatism) and their duration, onset of movement in relation to fall, tongue biting End of attack
  Nausea, vomiting, sweating, feeling of cold, confusion [lifeinthefastlane.com]

  • Syncope may be confused with seizure, cryptogenic drop attacks, migraine, basilar thrombosis, or metabolic disturbances. • Unlike true episodes of syncope, episodes of pseudosyncope are not associated with compromised cerebral circulation. [medlink.com]

• Vertigo

  RESULTS: In the current study sample, attacks of syncope were reported by 38 patients (4%) in association with the vertigo attack. [ncbi.nlm.nih.gov]

  Uusally associated with a prodrome (nausea/vomiting/vertigo/sweating). No post-ictal state, vs. seizures. [pedclerk.bsd.uchicago.edu]

  Syncope must be separated from seizures and other states of altered consciousness such as dizziness, vertigo, coma, and narcolepsy. [healthcentral.com]

• Drop Attacks

  These falls/attacks are called cryptogenic drop attacks. References:[5][12] The differential diagnoses listed here are not exhaustive. Treatment Complications References:[5] We list the most important complications. The selection is not exhaustive. [amboss.com]

  The classification chosen here only represents one possibility. 2.1 Vascular syncopes Orthostatic hypotension Stenosis of the cerebral arteries Subclavian-Steal-syndrome (" drop attack ") Takayasuís arteriitis Aneurysm of the internal carotid artery 2.2 [flexikon.doccheck.com]

  Autonomic failure 8.1.2 Epilepsy and ictal asystole 8.1.3 Cerebrovascular disorders 8.1.4 Migraine 8.1.5 Cataplexy 8.1.6 Drop attacks 8.2 Neurological tests 8.2.1 Electroencephalography 8.2.2 Brain computed tomography and magnetic resonance imaging 8.2.3 [escardio.org]

  […] tool=bestpractice.com It has many causes, and is distinct from vertigo, seizures, coma, falls, psychogenic pseudosyncope, drop attacks, transient ischaemic attacks, and states of altered consciousness. [3] Strickberger SA, Benson DW, Biaggioni I, et al [bestpractice.bmj.com]

• Altered Mental Status

  General examination notes patient’s mental status, including any confusion or hesitancy suggesting a postictal state and any signs of injury (eg, bruising, swelling, tenderness, tongue bite). [msdmanuals.com]

  Unlike patients with syncope, these patients will not return to baseline mental status but typically will have neurologic deficits, altered mental status, or severe headache. [reliasmedia.com]

  The AHA defines patients as unstable if any of the following are present: 17 Hypotension; New-onset altered mental status; Signs of shock; Ischemic chest discomfort; Acute heart failure. [emsworld.com]

In the absence of clinical suspicion, a routine diagnostic workup for APE in patients with syncope cannot be recommended. [ncbi.nlm.nih.gov]

Even at best, the SF Syncope Rule is not 100% sensitive, so if there is any concern for serious underlying disease, the patient should undergo further workup. [mdcalc.com]

Third, all participating hospitals used a standardized protocol for the diagnostic workup of syncope that was based on international guidelines, 1,2 but a specific workup was not mandated by the study protocol. [nejm.org]

Non‐pharmacological “physical” treatments are emerging as a new front line treatment of vasovagal syncope. [ncbi.nlm.nih.gov]

Psychogenic factors include: Fright Anxiety (due to the anticipation of discomfort or the fee) Stress Receipt of unwelcome news (treatment or the treatment fee) Sudden and unanticipated pain (injection or during treatment) The sight of blood (gauze, dental [dentalcare.com]

Using the latest science-based tools and treatments, our specialists offer a range of diagnosis and treatment options. [utswmed.org]

Treatment 5.1 General principles of treatment of syncope 5.2 Treatment of reflex syncope 5.2.1 Education and lifestyle modifications 5.2.2 Discontinuation/reduction of hypotensive therapy 5.2.3 Physical counter-pressure manoeuvres 5.2.4 Tilt training [escardio.org]

Are Any Medical Treatments Available For Vasovagal Syncope? In general the only treatment advised for people suffering from vasovagal syncope is to avoid triggering factors. [myheart.net]

Through the extensive Danish registries we examined the characteristics and prognosis of the patients hospitalized due to syncope in a nationwide study. [ncbi.nlm.nih.gov]

If syncope is symptomatic of an underlying condition, then the prognosis will reflect the course of the disorder. Prognosis Syncope is a dramatic event and can be life-threatening if not treated properly. [ninds.nih.gov]

Prognosis in cardiac syncope is much worse than in reflex-mediated conditions. [frontiersin.org]

Prognosis Cardiac syncope has a poorer prognosis than other forms of syncope. The 1-year endpoint mortality has been shown to be as high as 18-33%. [emedicine.com]

However, vascular etiologies can result in patient morbidity and mortality. [ncbi.nlm.nih.gov]

Given the wide variety of etiologies and concern over potentially missing an important etiology, diagnostic testing can become elaborate, expensive, and frequently low yield. [journalofhospitalmedicine.com]

Electrophysiologic study is reasonable in selected patients with syncope suspected of arrhythmic etiology (Class IIa). [acc.org]

Traditionally the data on epidemiology of syncope has been taken from smaller studies from different clinical settings with wide differences in patient morbidity. [ncbi.nlm.nih.gov]

There are also some difficulties interpreting epidemiological estimates because of inconsistencies in methodology and definitions used between studies. [bestpractice.bmj.com]

EPIDEMIOLOGY AND NATURAL HISTORY Syncope is a common presenting problem, accounting for approximately 3% of all emergency room visits and 1% of all hospital admissions. [accessmedicine.mhmedical.com]

In addition, long sinus pauses were noted during carotid sinus massage, suggesting that the two distinct entities may be associated, and further supporting the mechanism of neurally mediated syncope in the pathophysiology of swallow-induced syncope. [ncbi.nlm.nih.gov]

Definitions, classification and pathophysiology 3.1 Definitions 3.2 Classification and pathophysiology of syncope and transient loss of consciousness 3.2.1 Syncope 3.2.2 Non-syncopal forms of (real or apparent) transient loss of consciousness 4. [escardio.org]

Prevention & Risk Assessment Prevention & Risk Assessment What causes syncope? The common reason behind each syncopal or fainting episode is a temporary lack of oxygen-rich (red) blood getting to the brain. [childrensnational.org]

Although fainting itself might or might not be preventable, it is important to prevent injuries when people do faint. Fainting and related injuries after immunization can be prevented. [cdc.gov]

Prevention The best way to prevent vasovagal response is to avoid or manage common triggers: Sit or lie down during blood draws. Avoid hot, crowded, stuffy areas. Drink plenty of fluids. [innerbody.com]

VVS is not always completely preventable. However, a person may be able to reduce the number of fainting episodes that they experience. [medicalnewstoday.com]