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Syncope: Difference between revisions
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==Epidemiology== | ==Epidemiology== | ||
Syncope is common in the general population. The life-time cumulative incidence of ≥1 syncopal episodes in teenagers in the general population is high, with about 40 % by the age of 21 years. Reflex syncope is by far the most common cause. The majority have experienced reflex-mediated syncope episodes as teenagers and adolescents. The frequency of orhtostatic hypotension and cardiac syncope increases with age. Approximately 10-30% of the syncope episodes in patients above 60 years visiting a hospital for their syncope episodes are of cardiac origin. | Syncope is common in the general population. The life-time cumulative incidence of ≥1 syncopal episodes in teenagers in the general population is high, with about 40 % by the age of 21 years. Reflex syncope is by far the most common cause. The majority have experienced reflex-mediated syncope episodes as teenagers and adolescents. The frequency of orhtostatic hypotension and cardiac syncope increases with age. Approximately 10-30% of the syncope episodes in patients above 60 years visiting a hospital for their syncope episodes are of cardiac origin. | ||
==Clinical features== | |||
History taking is the most important feature in syncope evaluation. | |||
These clinical features suggestive of a specific cause of syncope: | |||
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! Reflex (neurally mediated) syncope | |||
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| Absence of cardiac disease | |||
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| Long history of syncope | |||
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| After sudden, unexpected, unpleasant sight, sound, smell, or pain | |||
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| Prolonged standing or crowded, hot places | |||
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| Nausea, vomiting associated with syncope | |||
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| During or in the absorptive state after a meal | |||
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| With head rotation, pressure on carotid sinus (as in tumous, shaving, tight collars) | |||
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| After exertion | |||
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! Syncope due to orthostatic hypotension | |||
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! Cardiac syncope | |||
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==Reflex syncope== | ==Reflex syncope== | ||