China
Africa
Explore chapters and articles related to this topic
Syncope
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Douglas L. Wood, Bernard J. Gersh
The evaluation of patients with syncope is facilitated by a careful history and physical examination, which will guide the physician in the selection of additional diagnostic studies. Several historical details may help in the differentiation of syncope from epilepsy, and the physical examination will often give clues to the presence of structural heart disease that might be associated with an arrhythmia.
Severe Tick-Borne Infections and Their Mimics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Praveen Sudhindra, Gary P. Wormser
Varying degrees of atrioventricular block, with or without fever, and multiple erythema migrans lesions occurring in the summer or fall months suggest a diagnosis of Lyme carditis. A chronic cardiomyopathy has been reported in European cases of Lyme disease but not in the United States. Rare fatalities have been reported in patients with complete heart block. The usual symptoms are syncope, dizziness, and malaise. In an older case series, multiple erythema migrans lesions were present in 75% of patients with cardiac manifestations [13]. These lesions may, however, go unnoticed unless a careful head-to-toe skin examination is performed. Although meningitis and cranial nerve palsies occur in the early disseminated phase of Lyme disease, these manifestations are rarely severe enough to warrant critical care evaluation [11,12].
General physical
Published in Keith Hopcroft, Vincent Forte, Symptom Sorter, 2020
The terminology in this area can be very confusing with words like ‘syncope’ and ‘faints’ being used imprecisely. Episodic loss of consciousness can occur in any age group, though it tends to be commoner in the elderly. It is a frightening experience for the patient, and it demands thorough examination, investigation and a low threshold for referral. For the GP, the differential widens the older the patient – and cardiac causes should not be overlooked in the elderly.
Daily Life Experiences: Challenges, Strategies, and Implications for Therapy in Postural Tachycardia Syndrome (POTS)
Published in Occupational Therapy In Health Care, 2022
Emily M. Rich, Asha Vas, Valerie Boyette, Carol Hollingsworth
Postural Tachycardia Syndrome (POTS) is a condition of autonomic dysfunction, characterized by excessive tachycardia with upright positioning in the absence of orthostatic hypotension (Arnold et al., 2018). POTS presents with a variety of symptoms associated with orthostatic intolerance, some of which persist in recumbency, and are often chronic in nature. Each individual diagnosed with POTS has a unique experience and presents with varying symptoms. Symptoms may include but are not limited to: tachycardia, pre-syncope, syncope, postural lightheadedness, palpitations, fatigue, pain, leg weakness, vertigo, visual symptoms, anxiety, and cognitive difficulties (Goodman, 2018). These symptoms impact function, with no specific treatment approach found to cure symptoms. Research on specific functional deficits as a result of symptoms of POTS is sparse and defined only in broad domains. Quality of life is affected, secondary to physical, psychological, and cognitive challenges associated with POTS (Bagai et al., 2011; Raj et al., 2018). Furthermore, due to the complex and varied presentation of symptoms, individuals with POTS are often misdiagnosed or undiagnosed for several years, prior to getting an accurate diagnosis (Shaw et al., 2019).
Syncope in patients with transthyretin amyloid cardiomyopathy: clinical features and outcomes
Published in Postgraduate Medicine, 2022
Gonzalo Barge-Caballero, Eduardo Barge-Caballero, Manuel López-Pérez, Raquel Bilbao-Quesada, Eva González-Babarro, Inés Gómez-Otero, Andrea López-López, Mario Gutiérrez-Feijoo, Alfonso Varela-Román, Carlos González-Juanatey, Óscar Díaz-Castro, María G. Crespo-Leiro
Nineteen (55.9%) out of 34 patients with syncope suffered ≥2 episodes of fainting. Relapsing syncope was attributed to a neurally mediated mechanism in four patients and to orthostatic hypotension in three patients. Cardiac causes of relapsing syncope were bradyarrhythmias (n = 5), tachyarrhythmias (n = 1), and aortic stenosis (n = 2). All patients with relapsing syncope of a cardiac origin stopped fainting after the cardiac cause of syncope was corrected, except 1 patient with a first episode of syncope due to third degree atrioventricular block who underwent pacemaker implantation and who suffered a subsequent episode of syncope due to orthostatic hypotension several months later. An underlying cause of syncope could not be identified in four patients, who were diagnosed with relapsing syncope of an unknown origin.
Insertable cardiac monitors: current indications and devices
Published in Expert Review of Medical Devices, 2019
Rafi Sakhi, Dominic A.M.J. Theuns, Tamas Szili-Torok, Sing-Chien Yap
Syncope is a relatively common clinical symptom in the general population with a lifetime incidence of 30–40% and is responsible for 3–6% of all emergency visits [15]. Despite extensive evaluation, a significant proportion of patients remain without a diagnosis [16–18]. Several studies from the ISSUE-investigators in the early 2000s demonstrated the diagnostic value of an ICM in different syncope populations such as those with neurally mediated syncope, bundle branch block or structural heart disease [19–21]. A meta-analysis of five randomized controlled trials comparing a conventional strategy (external loop recorder, tilt testing, and electrophysiological testing) to ICM implantation showed that an ICM provided a 3.6 increased relative probability of a diagnosis compared with the conventional strategy (46% versus 12%) [1,22–26]. Furthermore, an ICM strategy was more cost-effective than a conventional strategy [23,24]. Currently, an ICM is a well-established diagnostic tool in patients with recurrent unexplained syncope and should be employed in an early phase of evaluation [27].