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Syncope

Santiago O. Valdes, FAAP, MD and Alexander J Kiener, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Transient loss of consciousness characterized by unresponsiveness and loss of postural tone with spontaneous recovery; usually brief and caused by cerebral hypoperfusion

  • System(s) aff...

DIAGNOSIS

HISTORY

  • Careful history, physical exam, and an ECG are more important than other investigations in determining the diagnosis (1).

  • Make sure that the patient or witness (if present) is not ref...

TREATMENT

  • Initial therapy consists of maintaining good hydration status and normal salt intake. Educate patients of the premonitory signs of syncope (1)

  • Majority of pediatric patients improve with non...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Frequent follow-up visits for patients with cardiac causes of syncope, especially if on antiarrhythmics

  • Patients with an unknown cause of syncope...

REFERENCES

1
Shen  WK, Sheldon  RS, Benditt  DG, et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American College o...

SEE ALSO

  • Aortic Valvular Stenosis; Atrial Septal Defect; Carotid Sinus Hypersensitivity; Patent Ductus Arteriosus; Pulmonary Arterial Hypertension; Pulmonary Embolism; Seizure Disorders; Stokes-Adams ...

CODES

ICD10

R55 Syncope and collapse 

SNOMED

  • 271594007 Syncope (disorder)

  • 398665005 Vasovagal syncope (disorder)

  • 58077008 Hypotensive syncope

  • 234167006 Situational syncope

CLINICAL PEARLS

  • Careful history and physical exam are keys to a diagnosis.

  • Use the ECG/event-recorder to evaluate for arrhythmias.

  • Reflex-mediated vasovagal (neurally mediated syncope [NMS]/neurocardiog...

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