17 Syncope

Question 1

Single most “routine” test for patients with syncope

Answer 1

ECG

Question 2

Symptoms associated with syncope that should raise concern for an immediately life threatening diagnosis:

Answer 2

1. Chest pain
2. Palpitaions
3. Headache
4. Abdominal or back pain

Question 3

Considered a rare cause of brainstem ischemia.

Characterized by an abnormal narrowing of subclavian artery proximal to the origin of vertebral artery. Hence with exercise of the ipsilateral arm, blood is shunted (stolen) from the vertebrobasilar artery to the subclavian artery

Answer 3

Subclavian Steal Syndrome

Question 4

Most common structural cause of cardiac syncope in the elderly

Answer 4

Aortic Stenosis

Question 5

Least common cause of syncope according to the framingham heart study

Answer 5

Neurologic (4%)

Question 6

Significant predictors of adverse events according to the SAN FRANCISCO SYNCOPE RULE:

Answer 6

1. History of congestive heart failire
2. Abnormal ECG
3. Hct of <30%
4. A complaint of shortness of breath
5. SBP of <90mmHg in the ED