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Syncope A Case Presentation Edited

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Syncope Courtney McIlduff, M. Sc. Catherine Florio Pipas, M. D. Dartmouth Medical School
Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Presentation ,[object Object],[object Object],[object Object],[object Object]
Case Presentation: HPI ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Presentation: HPI ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Presentation: Medications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Presentation: PMH ,[object Object],[object Object],[object Object],[object Object],[object Object]
Case Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physical Exam ,[object Object],[object Object],[object Object],[object Object]
Initial Impression ,[object Object]
Definition of Syncope ,[object Object],[object Object],[object Object]
Syncope Stats ,[object Object],[object Object],[object Object],[object Object]
Syncope Stats continued ,[object Object],[object Object],[object Object],[object Object]
Differential Diagnosis of Syncope: Non-Cardiac vs Cardiac ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Category 1: Structural Causes of Cardiac Syncope ,[object Object],[object Object],[object Object],[object Object]
Category 2 : Arrhythmia as a Cause of Cardiac Syncope ,[object Object],[object Object],[object Object],[object Object]
Category 2: Arrhythmia as a Cause of Cardiac Syncope ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Category 2: Arrhythmia as a Cause of Cardiac Syncope ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Questions ,[object Object],[object Object]
Study: Context for Approaching Jackie’s Case ,[object Object],[object Object],[object Object],[object Object]
Study Results: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Study Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
First Distinction: Non-cardiac vs Cardiac ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Jackie: evidence for non-cardiac causes of syncope ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
But: evidence for cardiac cause of syncope ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Jackie: Diagnostic Studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Jackie: Further Diagnostic Studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],                                                   
Jackie: Update ,[object Object],[object Object],[object Object],[object Object],[object Object]
Jackie: Predicting Mortality ,[object Object],[object Object]
*-Abnormal electrocardiogram does not include sinus bradycardia or tachycardia or nonspecific ST- or T-wave changes alone. Ebell, Mark H. Syncope: initial evaluation and prognosis. American Family Physician 2006; 74(8): 1367-70. 27 3 or 4 16 2 9 1 1 0 One-year mortality rate (%) Number of risk factors History of ventricular arrhythmia History of congestive heart failure Age older than 45 years Abnormal electrocardiogram * Risk factors “ First Syncope Rule” Clinical Risk Score for Predicting One-Year Mortality in Patients with Syncope
What is Jackie’s Prognosis? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pop Quiz ,[object Object],[object Object]
Pop Quiz ,[object Object]
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Questions?
Thank you!
References & Resources ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Syncope A Case Presentation Edited

  • 1. Syncope Courtney McIlduff, M. Sc. Catherine Florio Pipas, M. D. Dartmouth Medical School
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  • 30. *-Abnormal electrocardiogram does not include sinus bradycardia or tachycardia or nonspecific ST- or T-wave changes alone. Ebell, Mark H. Syncope: initial evaluation and prognosis. American Family Physician 2006; 74(8): 1367-70. 27 3 or 4 16 2 9 1 1 0 One-year mortality rate (%) Number of risk factors History of ventricular arrhythmia History of congestive heart failure Age older than 45 years Abnormal electrocardiogram * Risk factors “ First Syncope Rule” Clinical Risk Score for Predicting One-Year Mortality in Patients with Syncope
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