Syncope

Definition

• Transient loss if consciousness that spontaneously resolves without deficits

Differential Diagnosis

• Cardiac
  • Arrhythmias
  • Valvular
    • Aortic stenosis
    • Mitral stenosis
  • Myocardial
    • Myocardial infarction
      • Inferior (vascular distribution affects conduction)
      • Large left coronary
    • Hypertrophic obstructive cardiomyopathy (HOCM)
  • Pericardial
    • Cardiac tamponade
• Neurological
  • Seizure
  • Stroke
• Reflex
• Vasovagal
• Carotid sinus hypersensitivity
• Situational
• Orthostatic
• Hypovolemic
• Drugs
  • Diuretics
  • CCBs
  • Beta blockers
• Dysautonomia
  • Diabetes mellitus
  • Parkinson's
  • Age
• Other
  • Respiratory
    • Pulmonary embolism
  • Psychiatric

Red flags

• Sudden drop (Stokes-Adams)
• Family history of sudden death
• EKG changes
• See ROSE rule for syncope