Transient loss of consciousness from global cerebral hypoperfusion with rapid onset and complete recovery.
Causes
- • Reflex/vasovagal
- • Orthostatic hypotension (drugs, autonomic dysfn)
- • Cardiac (arrhythmia, structural)
Clinical features
- • Prodrome (vasovagal) vs no warning (arrhythmic)
- • Post-event confusion suggests seizure not syncope
Investigations
- • 12-lead ECG (all patients)
- • Orthostatic BP
- • Echo if cardiac disease/murmur
- • Tilt table, Holter/loop recorder
- • CT brain if focal neuro deficit
Diagnosis
- • Canadian syncope risk score for ED disposition
Management
- • Vasovagal: education, salt/fluids, counter-manoeuvres
- • Cardiac: treat underlying cause; ICD if life-threatening VT
Educational — verify locally.
