UMEM Educational Pearls

  • Syncope is a sudden lack of blood supply to the brain typically caused by a problem in the regulation of blood pressure or a problem with the heart
  • Syncope can be broadly classified in 3 categories neural reflex (~60%), orthostatic (~15%), and cardiac (~15%) 
  • >Even in the absence of a firm diagnosis of cardiac syncope, the presence of known structural heart disease (CAD) or evidence a primary electrical disorder is associated with a poor prognosis
  • Cardiac causes of syncope can also be divided into 3 categories: structural heart disease, obstructive lesions, and arrhythmogenic potential
    • Structural: Ischemic heart disease, dilated cardiomyopathy, ARVD, 
    • Obstructive: HCM, aortic/mitral stenosis, atrial myxoma, pulmonary HTN, PE, tamponade
      • Brady: AV block, sick sinus, sinus arrest/pause
      • Tachy: SVT (AVNRT/AVRT), accessory pathways (WPW), or primary arrhythmias (LQTS, SQTS, CPVT, Brugada) 

References

Khoo C, Chakrabarti S, et al. Recognizing Life-Threatening Causes of Syncope. Cardiology Clinics. Volume 31, Feb, 2013