Causes

Question 1

List 6 HEAD pathologies that could cause syncope

Answer 1

• CVA / TIA
• Seizure
• Cancer
• Orthostatic hypertension
• Carotid stenosis
• Psychosis

Question 2

List 11 HEART pathologies that could cause syncope

Answer 2

• Myocardial infarction
• Arrhythmia
  
  • Tachycardia
  • Bradycardia
  • Long QT Syndrome
  • Brugada Syndrome
  • Wolf-Parkinson-White Syndrome (WPW)
• Aortic stenosis
• Obstructive cardiomyopathy
• Pacemaker malfunction
• Pericardial tamponade

Question 3

List 2 LUNG pathologies that could cause syncope

Answer 3

• Pulmonary embolism

- Tension pneumothorax

Question 4

List 15 VESSEL pathologies that could cause syncope

Answer 4

• Hypovolemia
  
  • ↓ Intake / ↑ Loss
• Toxins
  
  • Drugs
  • Alcohol
  • Prescription Rx
• Electrolytes
• Ammonia (hepatic encephalopathy)
• Vasodilation
• Sepsis
• Anaphylaxis
• Heat
• Aortic dissection
• Ruptured AAA
• Anemia
• Vasovagal

Question 5

List 16 VASOVAGAL pathologies that could cause syncope

Answer 5

• Carotid massage
  
  • Tie tightening
  • Shaving
• Defecation / Urination
• Post-Prandial (After eating)
• Post-Excersize
• Cough/Sneeze
• Trumpet playing
• Weight lifting
• Prolonged standing
• Bezold-Jarisch Reflex
  
  • Pain
  • Fright
  • Emotion
  • Blood loss
  • Needles

Question 6

Briefly explain the pathology of Bezold-Jarisch Reflex

Answer 6

Adrenergic stimuli (pain/emotion)

–> Exaggerated catecholamine release

↑ Sympathetic tone ++

↑ β1 contractility, before α1 can ↑preload

↑ Ventricular contraction on under-filled chamber

↑ Mechanoreceptor activation from exaggerated contractile force

–> Homeostatic vagal tone

↑ Vasodilation / Bradycardia ++

–> SYNCOPE