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Syncope - Differential Diagnosis
The percentage of syncopal events secondary to arrhythmias or structural disease is generally
Syncope - Differential ... percentage of syncopal ... Aortic stenosis • HOCM ... Others Non-syncopal ... Unknown - 2% #syncope
Syncope - Differential Diagnosis Framework
Reflex Syncope:
• Vasovagal: Prolonged standing, Stress, Pain
• Situational: Coughing, Sneezing, Micturition, Defecation,
Syncope - Differential ... Framework Reflex Syncope ... Aortic stenosis, HOCM ... , PE Syncope Mimics ... Cerebrovascular Syncope
HOCM on POCUS Echocardiogram (A4C)

85 yo s/p syncope. Here is the POCUS showing significant septal hypertrophy!
HOCM on POCUS Echocardiogram ... A4C) 85 yo s/p syncope ... diagnosed with HOCM ... MaimoUltrasound #HOCM
Syncope in 3 Steps
1. Consider the 3 "S" Mimics: Seizure, low Sugar, Stroke (TIA)
2. Heart vs
Syncope in 3 Steps ... • Pump > AS, HOCM ... amyloidosis and other #Syncope
Risk Factors for Sudden Cardiac Death in Patients with Hypertrophic Cardiomyopathy
 - Sudden death in a
Recent, unexplained syncope ... Cardiomyopathy #HOCM
Dizziness - Differential Diagnosis Framework
Vertigo:
 • Peripheral: Labyrinthitis, BPPV, Meniere's disease, Alternobaric
 • Central: CVA/TIA -
Temporal Lobe Pre-syncope ... Arrhythmia, AS/HOCM
WOBBLER  for ECG assessment in Syncope 
W - Wolff Parkinson White 
O - Obstructed AV
assessment in Syncope ... (consider AS, HOCM ... missed in the syncope ... elevation Now syncope ... and exertional syncope
Approach to ECGs - Syncope Syndromes
Electrolytes
 • ↑K - brady, peak T, wide QRS, no P,
Approach to ECGs - Syncope ... and short PR HOCM ... Wong @mchlwng #Syncope
This infographic provides a mnemonic tool called “WOBBLER” for assessing an ECG (electrocardiogram) in cases of
electrocardiogram) in cases of syncope ... potential causes of syncope ... cardiomyopathy (HOCM ... despite their syncope ... may explain the syncope
Recommended Therapeutic Approach to the Patient with Hypertrophic Cardiomyopathy (HOCM)
ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blockers;
Cardiomyopathy (HOCM ... #HOCM #HcM #Hypertrophic