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transient loss of consciousness due to global cerebral hypoperfusion
rapid onset, short duration and spontaneous complete recovery.
European Society of Cardiology guidelines 2009 ...
''Reflex'' syncope (neurally mediated) - most common though others inc as age inc
vasovagal: triggered by emotion, pain or stress. Often referred to as 'fainting'
situational: cough, micturition, gastrointestinal
carotid sinus syncope
''Orthostatic'' syncope
primary autonomic failure: Parkinson's disease, Lewy body dementia
secondary autonomic failure: e.g. Diabetic neuropathy, amyloidosis, uraemia
drug-induced: diuretics, alcohol, vasodilators
volume depletion: haemorrhage, diarrhoea
''Cardiac'' syncope
arrhythmias: bradycardias (sinus node dysfunction, AV conduction disorders) or tachycardias (supraventricular, ventricular)
structural: valvular, myocardial infarction, hypertrophic obstructive cardiomyopathy
others: pulmonary embolism
''Evaluation''
cardiovascular examination
postural blood pressure readings: a symptomatic fall in systolic BP > 20 mmHg or diastolic BP > 10 mmHg or decrease in systolic BP < 90 mmHg is considered diagnostic
ECG
carotid sinus massage
tilt table test
24 hour ECG