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Fortschritte Der Neurologie-Psychiatrie Aug 2020Syncopes are defined as sudden and short unconsciousness with loss of muscular tonus which are reversible without further intervention. Differentiation from other... (Review)
Review
Syncopes are defined as sudden and short unconsciousness with loss of muscular tonus which are reversible without further intervention. Differentiation from other short-lasting changes of consciousness as in seizures, blood flow abnormalities of brainstem, metabolic disorders, intoxication or traumatic loss of consciousness is important for further diagnostic and adequate treatment.
Topics: Diagnosis, Differential; Humans; Syncope
PubMed: 32818974
DOI: 10.1055/a-1165-7184 -
Current Pain and Headache Reports Jun 2018We review the literature on co-occurrence of syncope and headache and share clinical experience. (Review)
Review
PURPOSE OF REVIEW
We review the literature on co-occurrence of syncope and headache and share clinical experience.
RECENT FINDINGS
Headache in relation to syncope has been the subject of recent interest. Orthostatic intolerance has an expanding spectrum with three well-defined entities: orthostatic hypotension (OH), neurally mediated hypotension (NMH), and postural tachycardia syndrome (PoTS). Syncope occurs in patients with OH as well as in patients with episodically occurring NMH. Headache of OH is called coat-hanger ache (CHA) because it affects the neck and shoulders in a coat-hanger pattern. It can serve as a warning symptom of OH as well as a parameter to gauge the benefit of treatment. Awareness of CHA avoids inappropriate tests. Headache type occurring in NMH has not been fully delineated. A questionnaire-based study describes migraine leading to syncope and treatment of migraine to reduce syncope. Laboratory studies in NMH patients provide evidence for only short-duration headache. The author's approach to such patients is presented.
Topics: Headache; Humans; Syncope
PubMed: 29904895
DOI: 10.1007/s11916-018-0706-4 -
Circulation Aug 2017
Review
2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
Topics: Cardiology; Consensus; Humans; Predictive Value of Tests; Risk Factors; Syncope; Treatment Outcome
PubMed: 28280231
DOI: 10.1161/CIR.0000000000000499 -
Journal of the American College of... May 2021Syncope and presyncope lead to well over one million emergency room visits in the United States each year. Elucidating the cause of syncope or presyncope, which are...
Syncope and presyncope lead to well over one million emergency room visits in the United States each year. Elucidating the cause of syncope or presyncope, which are grouped together given similar etiologies and outcomes, can be exceedingly difficult given the diverse etiologies. This becomes more challenging as some causes, such as vasovagal syncope, are relatively innocuous while others, such as cardiac-related syncope, carry a significant increased risk of death. While the mainstay of syncope and presyncope assessment is a detailed history and physical examination, imaging can play a role in certain situations. In patients where a cardiovascular etiology is suspected based on the appropriate history, physical examination, and ECG findings, resting transthoracic echocardiography is usually considered appropriate for the initial imaging. While no imaging studies are considered usually appropriate when there is a low probability of cardiac or neurologic pathology, chest radiography may be appropriate in certain clinical situations. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Topics: Echocardiography; Evidence-Based Medicine; Humans; Societies, Medical; Syncope; United States
PubMed: 33958116
DOI: 10.1016/j.jacr.2021.02.021 -
International Journal of Cardiology Oct 2022
Topics: Adenosine; Humans; Syncope; Syncope, Vasovagal; Tilt-Table Test
PubMed: 35870636
DOI: 10.1016/j.ijcard.2022.07.036 -
Continuum (Minneapolis, Minn.) Apr 2017Syncope is a prevalent syndrome with diverse causes, which have in common a sudden transient failure of the autonomic nervous system to maintain blood pressure against... (Review)
Review
PURPOSE OF REVIEW
Syncope is a prevalent syndrome with diverse causes, which have in common a sudden transient failure of the autonomic nervous system to maintain blood pressure against the force of gravity at a level sufficient for cerebral perfusion. Neurally mediated syncope is an episodic phenomenon in which autonomic nervous system function is normal the rest of the time. Although relatively benign, syncope increases the risk for injury from falling and can substantially impair patients' quality of life. Recognition of its various clinical presentations and knowledge of the underlying pathophysiology are essential for accurate diagnosis and successful management.
RECENT FINDINGS
The most effective forms of treatment remain education of patients, avoidance of triggers, physical counterpressure maneuvers, and hydration or intravascular volume expansion. Pharmacologic interventions may be appropriate for some patients but, in general, have limited evidence of efficacy in preventing syncope. Based on the findings of a recent study, the possibility of pulmonary embolism should be considered in patients hospitalized for syncope, whether or not an alternative etiology for syncope is identified.
SUMMARY
This article focuses on the neurologic diagnosis, differential diagnosis, physiology, and management strategies for syncope, with an emphasis on neurally mediated syncope.
Topics: Adult; Female; Humans; Male; Middle Aged; Syncope
PubMed: 28375909
DOI: 10.1212/CON.0000000000000444 -
Pediatrics in Review Apr 2016
Topics: Adolescent; Female; Humans; Male; Medical History Taking; Physical Examination; Prognosis; Syncope
PubMed: 27037102
DOI: 10.1542/pir.2014-0109 -
Cardiology Clinics Aug 2015The occurrence of syncope while driving has obvious implications for personal and public safety. Neurally mediated syncope is the most common type of syncope in general... (Review)
Review
The occurrence of syncope while driving has obvious implications for personal and public safety. Neurally mediated syncope is the most common type of syncope in general and, thereby, also while driving. The presence of structural heart disease (reduced ejection fraction, previous myocardial infarction, significant congenital heart disease) potentially leads to high risk and should determine driving restrictions pending clarification of underlying heart disease and etiology of syncope. The clinical approach to syncope evaluation and recommendations for driving should not differ, whether or not the syncopal spell occurred while driving.
Topics: Automobile Driving; Electrocardiography; Global Health; Heart Diseases; Humans; Incidence; Prognosis; Risk Assessment; Risk Factors; Syncope
PubMed: 26115832
DOI: 10.1016/j.ccl.2015.04.014 -
Cardiology in Review 2015Carotid sinus hypersensitivity, first described less than 65 years ago, is an important and often undiagnosed cause of syncope in the elderly. Its pathophysiology is... (Review)
Review
Carotid sinus hypersensitivity, first described less than 65 years ago, is an important and often undiagnosed cause of syncope in the elderly. Its pathophysiology is complex and certain aspects are not completely understood. The timely diagnosis and treatment of this condition can improve morbidity and prevent complications in the elderly. In this article, the prevalence, risk factors, pathophysiology, diagnosis, aspects of carotid sinus massage, and treatment options for the different kinds of carotid sinus hypersensitivity are discussed.
Topics: Carotid Sinus; Electrocardiography; Global Health; Heart Rate; Humans; Morbidity; Syncope; Syndrome
PubMed: 25211534
DOI: 10.1097/CRD.0000000000000041 -
Revista Portuguesa de Cardiologia :... Sep 2023
Topics: Humans; Syncope; Reflex; Syncope, Vasovagal
PubMed: 37023980
DOI: 10.1016/j.repc.2023.04.001