Repeated episodes of syncope

Introduction Syncope (also known as sputum) is a transient loss of consciousness caused by transient ischemia and hypoxia. Syncope is a clinical syndrome, also known as fainting. This disease is caused by a sudden decrease in transient whole cerebral blood flow, temporary brain blood supply or insufficient oxygen supply, resulting in inhibition of reticular function and loss of consciousness; it lasts for a few seconds to several minutes; And fainted, but recovered faster. The causes of a sudden decrease in cerebral blood flow are: a sharp drop in blood pressure; a sudden decrease in cardiac output; an acute and extensive supply of blood to the cerebral arteries. The above three abnormalities are caused by a variety of different factors, and various factors can be related to each other. The syncope of some patients is multifactorial. Repeated episodes of syncope are often syncope, with certain repeatability.

Cause

The most basic cause of syncope is temporary insufficient blood supply to the brain.

an examination

Related inspection

Dynamic electrocardiogram (Holter monitoring)

Symptoms such as blood pressure drop, heart rate slow and weak, pale, should pay attention to the presence or absence of urinary incontinence, limb convulsions, biting the tongue and the duration of the attack.

Differential diagnosis

(a) Reflective syncope:

1, simple syncope: also known as vasovagal syncope, vascular decompression syncope. Clinically more common, there are obvious incentives before fainting, such as pain, high temperature, nervousness, fear, emotional, poor ventilation, air pollution, fatigue, persistent standing, hunger, pregnancy and the late stages of various chronic diseases.

2, upright low-pressure syncope: When the patient changes from the lying position to the upright position, the blood pressure drops rapidly and the cerebral blood flow is insufficient. When the symptoms of syncope appear, it is called orthostatic hypotension.

3, urinary syncope urinary syncope occurs in urination, or at the end of urination, causing decreased blood pressure and syncope. It most often occurs when the patient wakes up at midnight to urinate, and can also occur when urinating in the morning or in the nap.

4, carotid sinus syncope, also known as carotid sinus syndrome, is due to carotid artery stimulation, carotid atherosclerosis or its adjacent lesions, when the collar is too tight. Such as carotid sinus near the tumor, inflammation, trauma, traction or compression of the carotid sinus by external forces, etc. lead to carotid sinus syncope.

5, supine hypotension syncope mainly seen in the late stage of pregnancy, abdominal tumors, thrombophlebitis, inferior vena cava aponeurosis obstruction and venous primary leiomyoma. The main manifestations are: sudden drop in blood pressure, increased heart rate and syncope during supine. The mechanism is mainly due to the mechanical compression of the inferior vena cava by the mass, which causes the blood in the heart to suddenly decrease and is strange.

(2) Cardiac syncope:

Cardiac syncope is mainly caused by cardiac arrest, severe arrhythmia, myocardial ischemia, etc., which causes a sudden drop in blood output from the heart, and a lack of blood supply to the face causes syncope. Onset when standing upright, no obvious signs of aura are more suggestive of cardiac syncope or orthostatic hypotonic syncope. If the syncope in the supine position is more likely to be cardiogenic syncope.

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