Heat syncope: Difference between revisions

Latest revision as of 19:04, 28 September 2019

Variant of postural hypotension^[1]
- Results from combination of volume depletion, decreased vasomotor tone and peripheral vasodilatation
- Often precipitated by rapid change in position during exercise
- Occurs in nonacclimatized patients during early stages of heat exposure (especially elderly)

Cardiovascular-mediated syncope
- Dysrhythmias:
  - WPW (pre-excitation)
  - Long QT Syndrome/QT prolongation
  - Brugada Syndrome
  - Catecholaminergic polymorphic ventricular tachycardia
  - 2nd/3rd AV Block
  - Afib/aflutter
  - Vtach/torsades
  - Sick sinus syndrome
  - Arrhythmogenic right ventricular dysplasia
  - Short QT syndrome
- Cardiovascular disease
  - Valvular Disease (AS, MS, tricuspid stenosis)
  - Aortic Dissection
  - Myocardial Infarction
  - CHF
  - Hypertrophic Cardiomyopathy
  - PE
  - Pericardial Tamponade
  - Myxoma
  - Pulmonary Hypertension
  - Pacemaker malfunction
Neurally mediated syncope
- Vasovagal:
  - Fear, pain, emotion, valsalva, breath-holding spell
- Situational (associated with):
  - Coughing, micturition, defecation, vomiting, swallowing, postexercise
  - Carotid sinus stimulation
Orthostatic hypotension-mediated syncope:
- Volume depletion:
- Autonomic Dysreflexia
- Autonomic failure due to meds
Other serious causes
- Stroke
- SAH
- TIA
- Vertebrobasilar Insufficiency
- Subclavian steal
- Heat syncope
- Hypoglycemia
- Hyperventilation
- Asphyxiation
- Seizure
- Narcolepsy
- Psychogenic (anxiety, conversion disorder, somatic symptom disorder)
- Toxic (drugs, carbon monoxide, etc.)

↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339

Authors:

@@ Line 1: / Line 1: @@
 ==Background==
-#Variant of postural hypotension
+*Variant of postural [[hypotension]]<ref>Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339</ref>
-##Results from combination of volume depletion and peripheral vasodilatation
+**Results from combination of volume depletion, decreased vasomotor tone and peripheral vasodilatation
-##Occurs in nonacclimatized during early stages of heat exposure (esp elderly)
+**Often precipitated by rapid change in position during exercise
+**Occurs in nonacclimatized patients during early stages of heat exposure (especially elderly)
+==Clinical Features==
+*[[Syncope]] in the setting of environmental heat exposure
+==Differential Diagnosis==
+{{Template:Heat Emergencies}}
+{{Syncope causes}}
+==Evaluation==
+*Diagnosis of exclusion
 ==Management==
-##Diagnosis of exclusion
+*Supine position
-##Remove pt from heat source, give PO or IV rehydration
+*Remove patient from heat source
-##Hospitalization usually is not necessary
+*Give PO or [[IVF|IV]] rehydration
+==Disposition==
+*Hospitalization usually not necessary
+==See Also==
+*[[Heat Emergencies]]
-==Source==
+==References==
-Tintinalli
+<references/>
-[[Category:Environ]]
+[[Category:Environmental]]