SYNCOPE

Def....It consist of generalised weakness of muscle, los of postural tone, inability to stand upright and los of Consciousness
_fainting is lack of strength vth sensatiöns of impending los of los of consciousnes
_Faintness is podromal phase of fainting its characterisd by sequenc of event include Light headednes, blurring of vision proceeding to blackout, heavynes in lowr limbs and los of consciousnes

¤ MechanisM
_it s due to cerebral ischemia mainly to brain stem
_ischemia is due to sudden vasodialatiön and sudden fall in card. output

¤Types of syncope

1. Vasovagal syncope

_it is due to reflex slowing of heart mediated through vagus, and marked fall in arterial blod pres. And fall in PV resistance
_causes includ emotional stress, warm and ouercrowded room, sudden pain, mild blod los, anaemia, fever, fasting
.
.C/F
include prodromal phase characterisd by nausea, sweating, yawning, epigastric distress, tachypnea, weaknes, confusin. Ths s folowed by faintnes palor, coldnes of hand feet, weak pulse
_it s common in young people

2. Cardiac syncope

_it is due to sudden reduction in cardic output due to heart is beating to fast or to slow or nt at all
Causes
complte heart block, PSVT, sick sinus syndrome, MI, AS, PH, HCM, pul. Embolism, TOF

3. Orthostatic sncope
ths occur whn d person sudenly gets up 4m lying down position or stands still 4 long time
_basic mechanism is postural hypotensin due tn los of vasoconstrictor reflexes in lowr limb vessels
CauseS
PHysiological, idiopatihic orthostatic hypotnsn, anti hypertensive drugs, haemorrhage, diabetic neuropathy

4. Drug inducd SyncoP

_vasodialators/volume dplition e.g.ACE inhibitos, beta blocker, cc blockr, diuretics, nitrates
_arrhythmogenic
quinidine, amiodarone, TCAntidpresant

5.Miscellaneous cause of syncop
_vagal and glos6pharyngeal neuralgia
_micturition syncope in elderly pt
_cough syncope
_hypoglycaemia
_hyperventilation
_carotid sinus syncope