Jump to ContentJump to Main Navigation
Oxford Textbook of Medicine$
Users without a subscription are not able to see the full content.
Oxford Textbook of Medicine (5 ed.)

Edited by David A. Warrell, Timothy M. Cox, John D. Firth

Online access to the Oxford Textbook of Medicine in low and middle income countries is available through the World Health Organization-led HINARI Access to Research in Health programme. 

Latest update

The November 2012 update sees updates to over 70 chapters, focusing on Neurology and Gastroenterology. This update also incorporates a selection of 29 Case Histories taken from related titles in the Oxford Case Histories series, linked to from related chapters. Each case includes several questions followed by detailed answers and discussion to enhance diagnostic and clinical understanding.

Neurology updates include substantial updates to key chapters and new material on a wide range of topics including spinal cord injury, autonomic nervous system disorders, and inherited neurodegenerative diseases. 

Gastroenterology updates include extensive revisions of key chapters on liver failure and acute pancreatitis and new material on a wide range of matters, ranging from the common to the rare: including surgical treatments for colonic diverticular disease, antibody tests for immune disorders, and a revised treatment algorithm for small bowel bacterial overgrowth.

Access token activation

If you have an access token, please click here to activate it.

Sign up for an individual subscription to the Oxford Textbook of Medicine.

Publisher:
Oxford University Press
Print Publication Date:
May 2010
Print ISBN-13:
9780199204854
Published to Oxford Medicine:
May 2012
DOI:
10.1093/med/9780199204854.001.1

Subscriber Login

Forgotten your password?

Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Contents

Syncope

Chapter:
Syncope
Author(s):

A.J. Larner

DOI:
10.1093/med/9780199204854.003.240504_update_001

Update:

Chapter re-evaluated and minor changes made.

Updated on 28 November 2012. The previous version of this content can be found here.

Syncope is the commonest identified cause of transient loss of consciousness, being ten times more frequent than epilepsy. It is a consequence of cerebral underperfusion due to reduced cardiac output, often related to reduced venous return due to decreased peripheral vascular resistance, with pooling of blood volume in dependent body parts.

Causes

These include (1) neurally mediated—vasovagal; carotid sinus; situational, e.g. cough syncope; (2) orthostatic (postural) hypotension—autonomic failure; drug-induced; volume depletion; (3) cardiac arrhythmia; (4) cardiac/vascular structural disease—e.g. aortic stenosis.

Diagnosis, prognosis, investigations, and treatment

Diagnosis is clinical, based on history of the circumstances of the event obtained from the patient and reliable eyewitnesses; there is no other diagnostic test. In most patients, particularly those under 45 years of age, the condition is benign and self-limiting, with an excellent prognosis, requiring little investigation beyond physical examination and ECG to exclude heart disease. Cardiac causes of syncope may require specific treatment.

Oxford Medicine requires a subscription or purchase to access the full text of books within the service. Public users can however freely search the site and view the abstracts and keywords for each book and chapter.

Please, subscribe or login to access full text content.

If you think you should have access to this title, please contact your librarian.

To troubleshoot, please check our FAQs , and if you can't find the answer there, please contact us.