Syncope resident survival guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karol Gema Hernandez, M.D. [2]

Definition

Syncope is defined as a transient LOC, characterized by rapid onset, short duration and spontaneous complete recovery due to cerebral hypoperfusion.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

• Life threatening cause 1
• Life threatening cause 2
• Life threatening cause 3

Common Causes

• Common cause 1
• Common cause 2
• Common cause 3
• Common cause 4
• Common cause 5

Management

Diagnostic Algorithm for Syncope

Determine if there was LOC

If yes: ❑ Rapid onset? ❑ Short duration? ❑ Spontaneous complete recovery?

If no: ❑ Cataplexy ❑ Drop attacks ❑ Falls ❑ Functional /psychogenic pseudosyncope ❑ TIA of carotid origin

If no to ≥1; exclude the following before proceeding with syncope evaluation: ❑ Coma ❑ Aborted SCD ❑ Epilepsy ❑ Metabolic disorders: ♦ Hypoglycemia ♦ Hypoxia ♦ Hyperventilation with hypocapnia ❑ Intoxication ❑ Vertebrobasilar TIA

If yes: ❑ Transient LOC

Non traumatic

Traumatic

❑ Syncope ❑ Seizure ❑ Psychogenic

Algorithm based in 2009 ESC Guidelines for the Diagnosis and Management of Syncope.