Presyncope

Jump to: navigation, search

WikiDoc Resources for Presyncope

Articles

Most recent articles on Presyncope

Most cited articles on Presyncope

Review articles on Presyncope

Articles on Presyncope in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Presyncope

Images of Presyncope

Photos of Presyncope

Podcasts & MP3s on Presyncope

Videos on Presyncope

Evidence Based Medicine

Cochrane Collaboration on Presyncope

Bandolier on Presyncope

TRIP on Presyncope

Clinical Trials

Ongoing Trials on Presyncope at Clinical Trials.gov

Trial results on Presyncope

Clinical Trials on Presyncope at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Presyncope

NICE Guidance on Presyncope

NHS PRODIGY Guidance

FDA on Presyncope

CDC on Presyncope

Books

Books on Presyncope

News

Presyncope in the news

Be alerted to news on Presyncope

News trends on Presyncope

Commentary

Blogs on Presyncope

Definitions

Definitions of Presyncope

Patient Resources / Community

Patient resources on Presyncope

Discussion groups on Presyncope

Patient Handouts on Presyncope

Directions to Hospitals Treating Presyncope

Risk calculators and risk factors for Presyncope

Healthcare Provider Resources

Symptoms of Presyncope

Causes & Risk Factors for Presyncope

Diagnostic studies for Presyncope

Treatment of Presyncope

Continuing Medical Education (CME)

CME Programs on Presyncope

International

Presyncope en Espanol

Presyncope en Francais

Business

Presyncope in the Marketplace

Patents on Presyncope

Experimental / Informatics

List of terms related to Presyncope

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]

Synonyms and Keywords: Faintness; generalized weakness; lightheadedness; near blackout; near fainting; near syncope

Overview

Presyncope is a state consisting of lightheadedness,[1] muscular weakness, and feeling faint (as opposed to a syncope, which is actually fainting). Pre-syncope is most often cardiovascular in etiology. In many patients, lightheadedness is a symptom of orthostatic hypotension. Orthostatic hypotension occurs when blood pressure drops significantly when the patient stands from a supine or sitting position. If loss of consciousness occurs in this situation, it is termed syncope. Presyncope is frequently reported in patients with forms of Dysautonomia such as the Postural Tachycardia Syndrome. According to McGraw-Hill Concise Dictionary of Modern Medicine © 2002, presyncope is "An episode of near-fainting which may include lightheadedness, dizziness, severe weakness, blurred vision, which may precede a syncopal episode."

Causes

Life-Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Acute coronary syndrome, acute myocardial infarction, acute myocarditis, Adams-Stokes syndrome, anomalous origins of coronary arteries, aortic aneurysm, aortic dissection, aortic stenosis, arrhythmogenic right ventricular dysplasia, atrial myxoma, atrioventricular block, AV nodal reentrant tachycardia, bifascicular block, bradyarrhythmia, brugada syndrome, cardiac tamponade, catecholaminergic polymorphic ventricular tachycardia, channelopathy, complete atrioventricular block, dehydration, dilated cardiomyopathy, epsilon wave, hemorrhage, hypertrophic cardiomyopathy, hypotension, Jervell and Lange-Nielsen syndrome, long QT syndrome, mitral stenosis, orthostatic hypotension, paroxysmal ventricular tachycardia, persistent atrial flutter, preexcitation syndrome, prolonged corrected QT interval, pulmonic stenosis, retroperitoneal hemorrhage, ruptured abdominal aortic aneurysm, saddle embolus, second degree AV block, short corrected QT interval, short QT syndrome, sick sinus syndrome, significant sinus pause, subclavian steal syndrome, supraventricular tachyarrhythmia, third degree heart block, ventricular arrhythmia, ventricular tachycardia, Wolff-Parkinson-White syndrome
Chemical/Poisoning Carbon monoxide, cocaine, ethanol
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect ACE inhibitor, alpha blockers, amitriptyline, antiarrhythmics, antidepressants, antiemetics, antihypertensive medications, antipsychotic agents, barbiturates, beta blockers, bromocriptine, calcium channel blockerchlorpheniramine, cinnarizine, clonidine, desipramine, digoxin, diphenhydramine, diuretics, dothiepin, erectile dysfunction medications, Flurazepam, ganglionic blocker, hydralazine, hydroxyzine, L-dopa, nitrates, nortriptyline, opiates, phenothiazines, rizatriptan, tricyclic antidepressants, vasodilators
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Gastrointestinal bleeding
Genetic Channelopathy
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic Carotid sinus hypersensitivity, dysautonomia, Lewy body dementia, multiple system atrophy, parkinson disease, seizure, spinal cord injury, subarachnoid hemorrhage, transient ischemic attack, vagal stimulation, vertebrobasilar insufficiency
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Atrial myxoma, carcinoid syndrome
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric Anorexia nervosa, anxiety, emotional stress, hysterical faint, psychogenic pseudosyncope
Pulmonary Hypoxia
Renal/Electrolyte Uremia
Rheumatology/Immunology/Allergy Anaphylaxis, Takayasu's arteritis
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous Breath holding spells, choking game, cough, defecation, deglutition, drop attack, hair combing, heat illness, hyperventilation, hypocapnia, hypoglycemia, implanted cardioverter defibrillator malfunction, laughing, micturition, post-exercise, postprandial hypotension, prolonged bed rest, sneeze, significant blood loss, valsalva maneuver, vomiting, weightlifting

Causes in Alphabetical Order

Clinical test

The tilt table test is an evaluative clinical test to help identify presyncope or syncope.[6] A tilt angle of 60 and 70 degrees is optimal and maintains a high degree of specificity.[6] A positive sign with the tilt table test must be taken in context of patient history, with consideration of pertinent clinical findings before coming to a conclusion.

References

  1. Reeves, Alexander G. "Chapter 14: Evaluation of the Dizzy Patient". Disorders of the nervous system: a primer. Dartmouth Medical School. Retrieved 2012-01-06. Unknown parameter |coauthors= ignored (help)
  2. Khoo, C.; Chakrabarti, S.; Arbour, L.; Krahn, AD. (2013). "Recognizing life-threatening causes of syncope". Cardiol Clin. 31 (1): 51–66. doi:10.1016/j.ccl.2012.10.005. PMID 23217687. Unknown parameter |month= ignored (help)
  3. Kapoor, WN. (2000). "Syncope". N Engl J Med. 343 (25): 1856–62. doi:10.1056/NEJM200012213432507. PMID 11117979. Unknown parameter |month= ignored (help)
  4. Nishida, K.; Hirota, SK.; Tokeshi, J. (2008). "Laugh syncope as a rare sub-type of the situational syncopes: a case report". J Med Case Rep. 2: 197. doi:10.1186/1752-1947-2-197. PMID 18538031.
  5. Benbadis, SR.; Chichkova, R. (2006). "Psychogenic pseudosyncope: an underestimated and provable diagnosis". Epilepsy Behav. 9 (1): 106–10. doi:10.1016/j.yebeh.2006.02.011. PMID 16697264. Unknown parameter |month= ignored (help)
  6. 6.0 6.1 Natale, A., Akhtar, M., Jazayeri, M., Dhala, A., Blanck, Z., Deshpande, S., et al. (1995). Provocation of Hypotension During Head-Up Tilt Testing in Subjects With No History of Syncope or Presyncop. American Heart Association, (92), 54-58. doi: 10.1161/01.CIR.92.1.54; url: http://circ.ahajournals.org/content/92/1/54.full



Linked-in.jpg