Syncope and palpitation

2020 ◽  
pp. 3284-3293
Author(s):  
K. Rajappan ◽  
A.C. Rankin ◽  
A.D. McGavigan ◽  
S.M. Cobbe
Keyword(s):  
Orthostatic Hypotension ◽  
Cardiac Rhythm ◽  
Cerebral Hypoperfusion ◽  
Loss Of Consciousness ◽  
Neurocardiogenic Syncope ◽  
Cardiac Syncope ◽  
Appropriate Treatment ◽  
Heart Beating ◽  
Transient Episode ◽  
Premature Beats

Syncope is a transient episode of loss of consciousness due to cerebral hypoperfusion. Its causes can be subdivided on the basis of pathophysiology, including neurally mediated—or reflex—syncope; orthostatic hypotension; cardiac causes; and cerebrovascular or psychogenic causes. Neurocardiogenic syncope, or simple faint, is the commonest cause and is benign, but it is always important to exclude or establish the diagnosis of cardiac syncope, because this has an adverse prognosis that may be improved with appropriate treatment. Meanwhile, palpitation is the awareness of one’s heart beating—it may be due to an awareness of an abnormal cardiac rhythm, or an abnormal awareness of normal rhythm. It is most commonly due to premature beats (ectopics) and is benign. Correlation between symptoms and cardiac rhythm is the initial aim of investigations in patients presenting with palpitations.

Syncope and palpitations

2010 ◽  
pp. 2636-2642
Author(s):  
K. Rajappan ◽  
A.C. Rankin ◽  
A.D. McGavigan ◽  
S.M. Cobbe
Keyword(s):  
Heart Disease ◽  
Chest Pain ◽  
Cardiac Death ◽  
Cerebral Hypoperfusion ◽  
Loss Of Consciousness ◽  
Past Medical History ◽  
Cardiac Syncope ◽  
Appropriate Treatment ◽  
Cardiac Condition ◽  
History Of

Syncope is a transient episode of loss of consciousness (T-LOC) due to cerebral hypoperfusion. Its causes can be subdivided on the basis of pathophysiology, including (1) neurally mediated—or reflex—syncope; (2) orthostatic hypotension; (3) cardiac causes; and (4) cerebrovascular or psychogenic causes. Neurocardiogenic syncope, or simple faint, is the commonest cause and is benign, but it is always important to exclude or establish the diagnosis of cardiac syncope, because this has an adverse prognosis that may be improved with appropriate treatment. Cardiac arrhythmia should be considered in all patients who have syncope associated with any of the following: (1) exertion, chest pain, or palpitations; (2) a past medical history of heart disease; (3) abnormal cardiovascular findings on examination; (4) an abnormal ECG; and (5) a family history of sudden cardiac death in people younger than 40 years old or with an inherited cardiac condition....

Definition, epidemiology, classification, and pathophysiology

ESC CardioMed ◽  
2018 ◽  
pp. 2017-2021
Author(s):  
J. Gert van Dijk ◽  
Roland D. Thijs
Keyword(s):  
Cardiac Output ◽  
Orthostatic Hypotension ◽  
Epileptic Seizures ◽  
Cerebral Hypoperfusion ◽  
Loss Of Consciousness ◽  
Low Cardiac Output ◽  
Transient Loss Of Consciousness ◽  
Reflex Syncope ◽  
Cardiac Syncope ◽  
Transient Loss

Syncope can closely resemble other disorders with which it shares an apparent short-lived transient loss of consciousness. Together, these disorders are labelled as ‘transient loss of consciousness (T-LOC)’. Syncope is the form of T-LOC caused by cerebral hypoperfusion; the other main T-LOC forms are several types of epileptic seizures and the psychogenic conditions that resemble either syncope or epileptic seizures. The main forms of syncope are reflex syncope, syncope due to orthostatic hypotension, and cardiac syncope, also comprising cardiopulmonary causes and disorders of the great vessels. All forms of syncope share cerebral hypoperfusion and arterial hypotension as a final common pathway. They differ in the mechanism of hypotension: cardiac syncope is largely due to a low cardiac output, but in orthostatic hypotension and reflex syncope both low peripheral resistance and low cardiac output contribute to syncope. The clinical expression of the main forms is tightly linked to their pathophysiology, which is therefore important for differential diagnosis.

Definition, epidemiology, classification, and pathophysiology

ESC CardioMed ◽  
2018 ◽  
pp. 2017-2021
Author(s):  
J. Gert van Dijk ◽  
Roland D. Thijs
Keyword(s):  
Cardiac Output ◽  
Orthostatic Hypotension ◽  
Epileptic Seizures ◽  
Cerebral Hypoperfusion ◽  
Loss Of Consciousness ◽  
Low Cardiac Output ◽  
Transient Loss Of Consciousness ◽  
Reflex Syncope ◽  
Cardiac Syncope ◽  
Transient Loss

Syncope can closely resemble other disorders with which it shares an apparent short-lived transient loss of consciousness. Together, these disorders are labelled as ‘transient loss of consciousness (T-LOC)’. Syncope is the form of T-LOC caused by cerebral hypoperfusion; the other main T-LOC forms are several types of epileptic seizures and the psychogenic conditions that resemble either syncope or epileptic seizures. The main forms of syncope are reflex syncope, syncope due to orthostatic hypotension, and cardiac syncope, also comprising cardiopulmonary causes and disorders of the great vessels. All forms of syncope share cerebral hypoperfusion and arterial hypotension as a final common pathway. They differ in the mechanism of hypotension: cardiac syncope is largely due to a low cardiac output, but both low peripheral resistance and low cardiac output contribute to syncope due to orthostatic hypotension and reflex syncope. The clinical expression of the main forms is tightly linked to their pathophysiology, which is therefore important for differential diagnosis.

Syncope

2019 ◽  
pp. 251-258
Author(s):  
Ricardo Ruiz-Granell
Keyword(s):  
Patient Education ◽  
Orthostatic Hypotension ◽  
Pharmacological Treatment ◽  
Cerebral Hypoperfusion ◽  
Cardiac Syncope ◽  
Neurally Mediated Syncope

Syncope results from sudden, transient, global cerebral hypoperfusion. Neurally mediated syncope, orthostatic hypotension, arrhythmic and cardiac syncope, and steal syndromes are the main pathophysiological forms of syncope. This chapter focuses on the treatment of neurally mediated syncope and orthostatic syncope, since other forms of syncope are reviewed elsewhere. In neurally mediated and orthostatic syncope, patient education and non-pharmacological measures are the mainstay of treatment, although benefits of pharmacological treatment are not so evident.

scholarly journals Syncope of Obscure Nature

1979 ◽  
Vol 6 (1) ◽  
pp. 7-20 ◽  
Author(s):  
C. M. Fisher
Keyword(s):  
Abdominal Pain ◽  
Orthostatic Hypotension ◽  
Bowel Movement ◽  
Vasovagal Syncope ◽  
Anticonvulsant Therapy ◽  
Alcohol Ingestion ◽  
Loss Of Consciousness ◽  
Movement Response ◽  
Cardiac Syncope ◽  
Cold Drink

SummaryOne hundred and eleven cases of syncope or loss of consciousness are analyzed. Most are of obscure nature while some illustrate features of syncope that deserve further scrutiny. The cases are divided into six groups: 1) Resembling cardiac syncope (30 cases); 2) vasovagal syncope (22 cases); 3) features of both cardiac and vasovagal syncope (12 cases); 4) orthostatic hypotensive (29 cases); 5) akinetic seizure? (12 cases); and 6) miscellaneous (5 cases). Some groups are subdivided according to the circumstances surrounding the spells, for example, seated eating, nocturnal, associated with bowel movement, response to anticonvulsant therapy, etc. The following conclusions seem warranted: 1) The evidence favors the existence of a type of akinetic seizure resembling cardiac syncope; 2) loss of consciousness while seated eating (prandial syncope) may comprise a syndrome; 3) syncope related to bowel movement or abdominal pain is a striking association; 4)sporadic nocturnal syncope due to temporary hyp or e activity ofbaroreceptors is not sufficiently recognized; 5) alcohol ingestion may precipitate orthostatic hy-poreactivity of baroreceptors is not sufficiently recognized; 5) alcohol ingestion may precipitate orthostatic hypotension. Familial syncope, syncope proneness and cold drink syncope are illustrated.

Syncope

2019 ◽  
pp. 251-258
Author(s):  
Ricardo Ruiz-Granell
Keyword(s):  
Patient Education ◽  
Orthostatic Hypotension ◽  
Pharmacological Treatment ◽  
Cerebral Hypoperfusion ◽  
Cardiac Syncope ◽  
Neurally Mediated Syncope

Syncope results from sudden, transient, global cerebral hypoperfusion. Neurally mediated syncope, orthostatic hypotension, arrhythmic and cardiac syncope, and steal syndromes are the main pathophysiological forms of syncope. This chapter focuses on the treatment of neurally mediated syncope and orthostatic syncope, since other forms of syncope are reviewed elsewhere. In neurally mediated and orthostatic syncope, patient education and non-pharmacological measures are the mainstay of treatment, although benefits of pharmacological treatment are not so evident.

Transient loss of consciousness

2018 ◽  
Author(s):  
Jonathan Timperley ◽  
Sandeep Hothi
Keyword(s):  
Cardiovascular Disease ◽  
Orthostatic Hypotension ◽  
Short Duration ◽  
Complete Recovery ◽  
Complete Loss ◽  
Cerebral Hypoperfusion ◽  
Clinical Approach ◽  
Loss Of Consciousness ◽  
Transient Loss Of Consciousness ◽  
Transient Loss

Transient loss of consciousness (TLoC) is characterized by a rapid, transient, and complete loss of consciousness of short duration with spontaneous, complete recovery. Syncope is a specific type of TLoC caused by transient, global, cerebral hypoperfusion. TLoC may be traumatic or non-traumatic. Causes of non-traumatic TLoC include syncope, epilepsy, psychogenic causes, and other, rarer causes. Syncope may be reflex (neurally mediated), due to orthostatic hypotension or to cardiovascular disease. This chapter describes the clinical approach to the patient with transient loss of consciousness.

Case 24: Orthostatic Cerebral Hypoperfusion Syndrome with Vision Loss

2019 ◽  
pp. 157-162
Author(s):  
Peter Novak
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Orthostatic Hypotension ◽  
Flow Velocity ◽  
Blood Flow Velocity ◽  
Vision Loss ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Hypoperfusion ◽  
Tilt Test

The tilt test showed orthostatic cerebral hypoperfusion syndrome (OCHOS) with intermittent reduction in cerebral blood flow velocity and vision loss. OCHOS is associated with reduced orthostatic cerebral blood flow velocity without orthostatic hypotension or arrhythmia.

Case 23: Orthostatic Cerebral Hypoperfusion Syndrome, Severe

2019 ◽  
pp. 153-156
Author(s):  
Peter Novak
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Orthostatic Hypotension ◽  
Flow Velocity ◽  
Blood Flow Velocity ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Hypoperfusion ◽  
Tilt Test

The tilt test showed severe orthostatic cerebral hypoperfusion syndrome (OCHOS) with reduced cerebral blood flow velocity. OCHOS is associated with reduced orthostatic cerebral blood flow velocity without orthostatic hypotension or arrhythmia.

Sign in / Sign up

Export Citation Format

Share Document