syncope

  • syncope: short ddx
  • presyncope: very long ddx
  • good history is very important
    • differentiate between true syncope vs presyncope
    • does this sound like arrhythmia, tachy brady syndrome
    • cereral hypoperfusion
      • abrupt, no prodromal, no confusion
      • lights off/on
      • no tired/confused/postictal
    • PE: carotid sound
    • ECG

This patient has most likely experienced cardiogenic syncope due to ventricular tachycardia (VT); scarring from previous myocardial infarction (evidenced by Q waves on ECG) increases the risk of ventricular arrhythmia. Syncope due to VT usually has no warning symptoms (other than palpitations in some patients). The arrhythmia spontaneously terminates within a few minutes, resulting in restoration of cardiac output and rapid patient recovery with no residual symptoms.