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Algorithm for Syncope in the Emergency Department

Diagnosis and Workup

#Diagnosis #Management #Syncope #Algorithm #Workup
Algorithm for Syncope ... Diagnosis and Workup ... Diagnosis #Management #Syncope ... #Algorithm #Workup
Differential Diagnosis of Syncope
First, is it syncope? History is very important for distinguishing syncope from other
from other causes ... Common causes of ... syncope and their ... #Causes #Differential ... #Algorithm #Ddxof
Syncope - Differential Diagnosis
The percentage of syncopal events secondary to arrhythmias or structural disease is generally
Syncope - Differential ... percentage of syncopal ... Sick sinus, AV block ... Others Non-syncopal ... differential #diagnosis #causes
Pacemaker Placement Indications
Class I:
 • Third degree block
 • Advanced 2nd degree block
 • Symptomatic Mobitz
with syncope • ... RBBB/LBBB with syncope ... Class Ill: • Syncope ... LaFB without sx/syncope ... • Reversible causes
Causes of Syncope #Diagnosis #EM #IM #Neuro #Syncope #Differential #Algorithm #Ddxof
Causes of Syncope ... EM #IM #Neuro #Syncope ... #Differential #Algorithm
Shock - Differential Diagnosis by Classification
Reflex Syncope 
 - Vasovagal syncope
   • Prolonged standing
- Vasovagal syncope ... - Situational syncope ... bradycardia • Sinus pauses ... • AV block ... Classification #Table #Causes
Syncope - Differential Diagnosis Framework
Reflex Syncope:
• Vasovagal: Prolonged standing, Stress, Pain
• Situational: Coughing, Sneezing, Micturition, Defecation,
Syncope - Differential ... Framework Reflex Syncope ... bradycardia, Sinus pauses ... , AV block • Tachyarrhythmias ... Cerebrovascular Syncope
Approach to ECGs - Syncope Syndromes
Electrolytes
 • ↑K - brady, peak T, wide QRS, no P,
Approach to ECGs - Syncope ... assoc with 1K, AV block ... Trifascicular block ... Wong @mchlwng #Syncope ... diagnosis #cardiology #electrocardiogram
WOBBLER  for ECG assessment in Syncope 
W - Wolff Parkinson White 
O - Obstructed AV
- Bifascicular block ... or 3rd degree block ... B bifascicular block ... , can be caused ... characteristically cause
Complete (3rd Degree) Heart Block on ECG

ECG of a man brought to the ER by paramedics
Degree) Heart Block ... an episode of syncope ... HeartBlock #ECG #EKG #Electrocardiogram