Cough syncope

Introduction Coughing syncope is a loss of consciousness immediately after a severe cough, with low muscle tone and short duration. A small number of patients felt dizzy and dazzled, and their complexion changed from bruising to pale and sweating. Most of the patients were obese men after middle age, who often smoked and had bronchitis and emphysema. Children who developed pertussis or asthma also developed symptoms. Most after repeated coughing, occasionally fainted after a single cough, call, sneezing, yawning or laughing. Cough increases the intrathoracic pressure, causing venous return obstruction and cardiovascular reflex factors to play a role in the disease.

Cause

More common in male patients with chronic respiratory diseases (such as chronic bronchitis, emphysema, etc.), can also be seen in atrioventricular block, obstructive cardiomyopathy, carotid sinus allergy, atherosclerosis.

an examination

Related inspection

Brain ultrasound examination of electrocardiogram

Immediately after the severe cough, loss of consciousness occurs, the whole body muscle tension is low, the complexion is pale, the pulse is weak, and the standing person may fall. In severe cases, the facial muscles and limbs are convulsions, and the complexion is blued. Mild patients can be lost unconsciously. After a few seconds to a few minutes, the breathing gradually rules, and then the consciousness is clear. There was no obvious headache, lethargy, etc. after the attack, and the number of episodes was uncertain.

The medical history has the history of the above-mentioned diseases, and can be diagnosed based on the above clinical manifestations and auxiliary examinations and the elimination of syncope caused by epilepsy or other causes.

Differential diagnosis

Differential diagnosis of cough syncope:

1. Vasoconstrictive syncope: There are obvious causes of seizures such as emotional instability, fatigue, pre-existing symptoms such as sweating, drooling, bradycardia and other prodromal symptoms. The above symptoms last for tens of seconds to several minutes and loss of consciousness. The blood pressure drops, the pulse is weakened, and the consciousness is lost for a few seconds to several tens of seconds to wake up on its own.

2. Upright hypotensive syncope: A sport that occurs when the level of position suddenly changes to an upright position, the loss of consciousness is sudden, there is no prodromal symptoms, and the symptoms and signs at the time of onset are the same as vasoconstrictive syncope.

3. Paroxysmal weakness: can be seen in the rowing athletes. A few minutes after the completion of the game, the collapse occurred, followed by obvious weakness, and the duration of syncope was only a few seconds.

4. Sudden loss of primary consciousness: athletes with low training level have poor adaptability to the cardiovascular system, can not adapt to high-intensity exercise load, are prone to hypoxia and hypocapnia, and are confused before the attack. The degree of loss is deep, the complexion is gray, the corneal reflex disappears, and the syncope lasts for a long time. After waking, the scene at the last moment of the game cannot be memorized, and after awakening, there are nervous system symptoms such as aphasia.

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