Syncope = Sudden, temporary loss of consciousness due to ↓ blood flow to the brain.
Presyncope = Feeling lightheaded or about to faint (near-collapse).
Mnemonic:
"FAINT" (Symptoms of Syncope)
- Falling
suddenly
- Absence of
consciousness (brief)
- Irregular or
slow heartbeat
- Nausea or
dizziness before fainting
- Transient
recovery (wakes up fast)
CAUSES OF SYNCOPE
1. CARDIAC
SYNCOPE (Dangerous!)
• Arrhythmias – Slow or fast heartbeats cause ↓ blood flow.
• Structural Heart Disease – Aortic stenosis, hypertrophic
cardiomyopathy, heart attack.
• Carotid Sinus Syndrome – Pressure on the carotid artery
(tight collar, shaving) causes sudden fainting.
Mnemonic:
"CAR" (Cardiac Causes)
- Carotid
Sinus Syndrome
- Arrhythmias
- Reduced
Heart Output (Heart Disease)
2. VASOVAGAL
SYNCOPE (Common, Harmless!)
• Triggered by standing too long, heat, emotional stress, pain, or
seeing blood.
• Causes slow heart rate & blood vessel dilation, leading
to fainting.
• Diagnosed by Tilt Table Test (Patient tilted at 70° to check
BP drop).
Mnemonic:
"VASO" (Vasovagal Causes)
- Vagal Overreaction
- Anxiety
& Emotional Stress
- Standing for
long periods
- Overheat or
Full Stomach
3. POSTURAL
(ORTHOSTATIC) HYPOTENSION
• Blood pressure drops when standing up suddenly.
• Common in dehydration, anemia, old age, diabetes, and Parkinson’s
disease.
• Medications like antidepressants, diuretics, and vasodilators
can worsen it.
Mnemonic:
"DOPA" (Postural Hypotension Causes)
- Dehydration
- Old Age
- Parkinson’s
& Diabetes
- Antihypertensive
Drugs
4. SITUATIONAL
SYNCOPE (Triggers!)
• Fainting occurs due to specific triggers like coughing, urination,
or swallowing.
• Examples: Cough Syncope, Micturition Syncope, Swallow Syncope.
Mnemonic:
"CUTS" (Situational Syncope Triggers)
- Cough
- Urination
- Triggers
like swallowing
- Stress
DIAGNOSIS OF
SYNCOPE
- History & Triggers – Most important!
- ECG & Holter Monitor – Check for arrhythmias.
- Tilt Table Test – For vasovagal syncope.
- Carotid Sinus Massage – To check for Carotid Sinus Syndrome.
- Blood Tests – Check anemia, thyroid, electrolytes.
Mnemonic:
"HEART" (Tests for Syncope)
- History
& Triggers
- ECG &
Holter
- Autonomic
Tests (Tilt Table, Carotid Massage)
- Rule out
Blood Loss (Anemia, BP Drop)
- Through
Blood Tests
TREATMENT OF
SYNCOPE
1. GENERAL
MEASURES
- Lie Down Immediately if Feeling Dizzy
- Raise Legs to improve blood flow to the brain
- Avoid Triggers (Heat, Standing Too Long, Stress)
- Stay Hydrated
2. SPECIFIC
TREATMENT
• Cardiac Syncope → Pacemaker, Beta-Blockers
• Vasovagal Syncope → Tilt Training, Salt Intake,
Beta-Blockers
• Postural Hypotension → Slow Position Changes,
Elastic Stockings, Fludrocortisone
• Situational Syncope → Avoid Known Triggers
Mnemonic:
"FAST" (First Aid for Syncope)
- Flat
Position (Lie Down)
- Avoid
Triggers
- Stay
Hydrated
- Tilt Legs Up
FINAL REVISION WITH MNEMONICS
- Symptoms = "FAINT" (Fall, Absence of Consciousness, Irregular HR, Nausea, Transient Recovery)
- Cardiac Causes = "CAR" (Carotid, Arrhythmias, Reduced Output)
- Vasovagal = "VASO" (Vagal, Anxiety, Standing, Overheat)
- Postural Hypotension = "DOPA" (Dehydration, Old Age, Parkinson’s, Antihypertensives)
- Situational = "CUTS" (Cough, Urination, Triggers, Stress)
- Diagnosis = "HEART" (History, ECG, Autonomic Tests, Rule Out BP Drop, Tests)
- First Aid = "FAST" (Flat Position, Avoid Triggers, Stay Hydrated, Tilt Legs)
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