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Syncope and palpitations 

Syncope and palpitations
Chapter:
Syncope and palpitations
Author(s):

K. Rajappan

, A.C. Rankin

, A.D. McGavigan

, and S.M. Cobbe

DOI:
10.1093/med/9780199204854.003.160202_update_001

Update:

Classification and investigation of orthostatic hypotension

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date: 24 February 2021

Syncope is a transient episode of loss of consciousness (T-LOC) due to cerebral hypoperfusion. Its causes can be subdivided on the basis of pathophysiology, including (1) neurally mediated—or reflex—syncope; (2) orthostatic hypotension; (3) cardiac causes; and (4) cerebrovascular or psychogenic causes.

Neurocardiogenic syncope, or simple faint, is the commonest cause and is benign, but it is always important to exclude or establish the diagnosis of cardiac syncope, because this has an adverse prognosis that may be improved with appropriate treatment. Cardiac arrhythmia should be considered in all patients who have syncope associated with any of the following: (1) exertion, chest pain, or palpitations; (2) a past medical history of heart disease; (3) abnormal cardiovascular findings on examination; (4) an abnormal ECG; and (5) a family history of sudden cardiac death in people younger than 40 years old or with an inherited cardiac condition....

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