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SyncopeSyncope is defined as a sudden, transient loss of consciousness characterized by unresponsiveness and loss of postural tone. The prognosis for most persons with syncopal episodes is good; however, persons with syncope caused by a cardiac disorder have a one-year mortality rate of 20-30% and a 33% incidence of sudden death over 5 years. Persons with noncardiac causes or syncope of unknown origin have a relatively benign prognosis. Hospitalization is generally not necessary, unless a cardiac etiology or a significant injury during the syncopal event ventricular arrhythmias, arrhythmias, heart beat, palpitations, arithmia, arhythmia, arrhythmia is sincope Syncope Fainting Syncope Fainting Pathophysiology Vasovagal attacks, cardiac disorders and pulmonary outflow obstruction produce syncope because of a reduction of cerebral blood Hypoxia, hyperventilation and hypoglycemia, increased intracranial pressure, seizures and hysteria can cause syncope. Vasovagal episodes cause reflex syncope secondary to underfilling of the right side of the heart. Cardiac syncope is caused by inadequate output from the left ventricle. Mechanical causes of cardiac syncope include aortic stenosis, hypertrophic cardiomyopathy, myocardial infarction and pulmonary embolus. Tachyarrhythmias, especially ventricular tachycardia, account for most of the arrhythmias that result in cardiac syncope. Syncope of cardiac origin results in markedly increased rates of mortality and sudden death. The cause of syncope can not be determined in 38-47% of
Clinical EvaluationThe history and physical examination can identify potential causes of syncope in 50-85% of cases in which a successful diagnosis is made. A young, healthy patient with a history compatible with vasovagal syncope probably needs HistoryA complete description of the syncopal episode, prodromal circumstances and symptoms following the syncopal episode should be obtained. The relationship of fainting to micturition, defecation, cough, swallowing or postural change may reveal a |