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Syncope is the sudden temporary reversible loss of consciousness associated with postural tone and it relates to a loss of blood supply to the brain causing the patient to fall to the floor. It is part of the TLOC or transient loss of consciousness spectrum
Key information comes from the history and it can take quite a while. It is important that we hear about every aspect of the patient’s most recent event and ensure to ask all of the following questions:
If there are six blackouts, then the above must be asked for each of those six events.
Other key pieces of information to ask in an extended history:
When thinking about a diagnosis of faint consider the Three P’s:
When considering cardiac, most patients will have a cardiac history. When considering epilepsy factors to consider:
If there is very frequent fainting, consider an uncommon autonomic problem, postural orthostatic tachycardia syndrome with lots of systemic autonomic features such as bowel disturbance, bladder disturbance, migraines, Raynaud’s.
An ECG shows a suspicion of left ventricular hypertrophy. Which underlying cause should you consider in this patient?
You suspect hypertrophic obstructive cardiomyopathy on the basis of the patient’s history and ECG findings. Which investigation would you organise next?
Which of the following conditions is associated with HOCM.
How is familial HOCM inherited?
Multiple genetic mutations may give rise to HOCM, but what do the causal genes encode?