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Syncope

Judson A. Moore, MD and Santiago O. Valdes, MD, FAAP Reviewed 06/2019
 


BASICS

DESCRIPTION

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

  • System(s) affect...

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 talk...

TREATMENT

  • Maintaining good hydration status and normal salt intake are initial therapy. Educate patients of the premonitory signs of syncope (1),(3)[B].

  • Majority of pediatric patients improve with nonp...

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 of Cardiology/American Heart...

ADDITIONAL READING

  • Anderson JB, Willis M, Lancaster H, et al. The evaluation and management of pediatric syncope. Pediatr Neurol.  2016;55:6–13. [View Abstract on OvidMedline]

  • Puppala VK, Akkaya M...

CODES

ICD10

R55 Syncope and collapse 

ICD9

780.2 Syncope and collapse 

SNOMED

  • 271594007 Syncope (disorder)

  • 398665005 Vasovagal syncope (disorder)

  • 58077008 Hypotensive syncope

  • 234167006 Situational syncope

CLINICAL PEARLS

  • Careful history and physical exam is key to a diagnosis.

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

  • NMS is the most common cause in children and adults.

  • True neurologic cause...

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