- Classification
Classification | Pathophysiology | Discriminating clinical features |
Cardiac Syncope | ㅤ | ㅤ |
Arrhythmia | Tachyarrhythmia, Bradyarrhythmia | Palpitations, HR, ECG, cardiac history, family history, ECHO |
Structural cardiac disease | Valve disease, Outflow obstruction | Abnormal cardiac exam, ECG, cardiac history, family history, ECHO |
Pacemaker malfunction | ㅤ | ECG, pacemaker check |
Non-Cardiac Syncope | ㅤ | ㅤ |
Neurocardiogenic, Cardioinhibitory, Vasodepressor | Exaggerated vagal response to stimulus | Prolonged standing, heat, situational, normal exam, normal ECG, tilt table test |
Orthostatic hypotension | Autonomic failure (diabetes, Parkinson's), Drug induced | Change in body position, lying/standing BP, ECG, drop in BP without change in HR, medication history |
Seizure | - | Preceding aura, rhythmic jerking, unresponsive, tongue biting, urinary incontinence, post-ictal period, known epilepsy, Babinski positive, pupillary response |
CVA/TIA | Hemorrhage/infarct | Other neurological symptoms, fall due to weakness/loss of balance rather than syncope |
Vertigo | Steal phenomenon, BPPV | Room spinning, nystagmus |
Others | Hypoglycemia, Dehydration | ㅤ |
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