Syncope classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]: Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]

Overview

Syncope is usually classified based on the underlying mechanisms leading to hypoperfusion. According to European Society of Cardiology (ESC) guideline, syncope is classified to neurally-mediated, orthostatic hypotension, and cardiovascular subtypes. There are some conditions that are incorrectly diagnosed as syncope. These conditions are usually associated with partial or complete loss of consciousness such as epilepsy, metabolic disorders, transient ischemic attack or conditions with loss of posture and without loss of consciousness like cataplexy, drop attacks, falls and pseudo-syncope.

Classification

Syncope is usually classified based on the underlying mechanisms leading to hypoperfusion. According to European Society of Cardiology (ESC) guideline, syncope is classified to:

There are some conditions that are incorrectly diagnosed as syncope. These conditions are usually associated with partial or complete loss of consciousness or with loss of posture and without loss of consciousness. The table below is one of the suggested classification systems for syncope:[1]

Neurally-Mediated Syncope
Vasovagal
  • Triggered by emotional distress
Situational
  • Micturition
  • Others:
    • Weight lifting
    • laughter
    • Brass instrument playing
Carotid sinus syncope
Syncope due to Orthostatic Hypotension
Autonomic failure
Drug induced:
Volume depletion
Cardiovascular Syncope
Arrhythmia
Structural heart disease
Other cardiovascular:
Conditions Incorrectly Diagnosed as Syncope
Disorders with partial or complete loss of consciousness
  • Vertebrobasilar TIA
Conditions without loss of consciousness
  • Functional (pseudoscope)
  • Drop attacks
  • TIA of carotid origin
The above table adopted from ESC guideline

References

  1. Moya, A.; Sutton, R.; Ammirati, F.; Blanc, J.-J.; Brignole, M.; Dahm, J. B.; Deharo, J.-C.; Gajek, J.; Gjesdal, K.; Krahn, A.; Massin, M.; Pepi, M.; Pezawas, T.; Granell, R. R.; Sarasin, F.; Ungar, A.; van Dijk, J. G.; Walma, E. P.; Wieling, W.; Abe, H.; Benditt, D. G.; Decker, W. W.; Grubb, B. P.; Kaufmann, H.; Morillo, C.; Olshansky, B.; Parry, S. W.; Sheldon, R.; Shen, W. K.; Vahanian, A.; Auricchio, A.; Bax, J.; Ceconi, C.; Dean, V.; Filippatos, G.; Funck-Brentano, C.; Hobbs, R.; Kearney, P.; McDonagh, T.; McGregor, K.; Popescu, B. A.; Reiner, Z.; Sechtem, U.; Sirnes, P. A.; Tendera, M.; Vardas, P.; Widimsky, P.; Auricchio, A.; Acarturk, E.; Andreotti, F.; Asteggiano, R.; Bauersfeld, U.; Bellou, A.; Benetos, A.; Brandt, J.; Chung, M. K.; Cortelli, P.; Da Costa, A.; Extramiana, F.; Ferro, J.; Gorenek, B.; Hedman, A.; Hirsch, R.; Kaliska, G.; Kenny, R. A.; Kjeldsen, K. P.; Lampert, R.; Molgard, H.; Paju, R.; Puodziukynas, A.; Raviele, A.; Roman, P.; Scherer, M.; Schondorf, R.; Sicari, R.; Vanbrabant, P.; Wolpert, C.; Zamorano, J. L. (2009). "Guidelines for the diagnosis and management of syncope (version 2009): The Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC)". European Heart Journal. 30 (21): 2631–2671. doi:10.1093/eurheartj/ehp298. ISSN 0195-668X.



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