Heat syncope: Difference between revisions
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==Background== | ==Background== | ||
*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> | *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, decreased vasomotor tone and peripheral vasodilatation | **Results from combination of volume depletion, decreased vasomotor tone and peripheral vasodilatation | ||
**Often precipitated by rapid change in position during exercise | **Often precipitated by rapid change in position during exercise | ||
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==Clinical Features== | ==Clinical Features== | ||
*Syncope in the setting of environmental heat exposure | *[[Syncope]] in the setting of environmental heat exposure | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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*Supine position | *Supine position | ||
*Remove patient from heat source | *Remove patient from heat source | ||
*Give PO or IV rehydration | *Give PO or [[IVF|IV]] rehydration | ||
==Disposition== | ==Disposition== | ||
Latest revision as of 19:04, 28 September 2019
Background
- 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)
Clinical Features
- Syncope in the setting of environmental heat exposure
Differential Diagnosis
Environmental heat diagnoses
Syncope Causes
- Cardiovascular-mediated syncope
- Dysrhythmias:
- Cardiovascular disease
- Neurally mediated syncope
- Vasovagal:
- Fear, pain, emotion, valsalva, breath-holding spell
- Situational (associated with):
- Vasovagal:
- 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.)
Evaluation
- Diagnosis of exclusion
Management
- Supine position
- Remove patient from heat source
- Give PO or IV rehydration
Disposition
- Hospitalization usually not necessary
See Also
References
- ↑ Waters T. Heat Emergencies In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. McGraw Hill Medical. 2011: 1339