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Handbook of Syncope: A Concise Clinical Approach
Behzad B Pavri
CHAPTER 1:
Historical Aspects, Definition, and Epidemiology
INTRODUCTION
DEFINITION
EPIDEMIOLOGY
CHAPTER 2:
Overview of the Causes of Syncope
INTRODUCTION
CAUSES OF SYNCOPE
Cardiovascular Disorders
Syncope Related to Obstruction of Cardiac Output
Syncope Related to Cardiac Arrhythmia
Disorders of Vascular Control or Blood Volume
Cerebrovascular/Neurologic Disorders that can Result in “Loss of Consciousness”
Miscellaneous Causes of syncope/Mimics of Syncope
Multifactorial Syncope (More Common in Older Patients)
Syncope of Undetermined Cause
CHAPTER 3:
Approach to the Syncopal Patient—Importance of History, Physical Examination, and ECG
HISTORY
Questions to be Posed to a Patient with Syncope
Questions to be Posed to the Person who Witnessed the Patient with Syncope
Historical Features of Vasovagal/Neurocardiogenic Syncope
Historical Features of Arrhythmic (Bradycardia or Tachycardia) Syncope
Historical Features Associated with Syncope due to Congenital Arrhythmic Syndromes
Historical Features Associated with Neurologic Syncope (Seizures)
PHYSICAL EXAMINATION
Carotid Sinus “Massage”
ROLE OF THE RESTING ELECTROCARDIOGRAM IN THE SYNCOPAL PATIENT
Holter/Mobile Cardiac Outpatient Telemetry
Implantable Loop Recorder
RISK-ASSESSMENT OF THE SYNCOPAL PATIENT
CONCLUSIONS AND FUTURE DIRECTIONS
CHAPTER 4:
Additional Tests used in the Evaluation of the Syncopal Patient
INTRODUCTION
HEAD-UP TILT TABLE TESTING
EXERCISE STRESS TESTING
COMPREHENSIVE ELECTROPHYSIOLOGY STUDY
ROLE OF NEUROLOGIC TESTING AND ELECTROENCEPHALOGRAMS
CHAPTER 5:
The Medicolegal Aspects of Syncope: Driving, Flying, and Sports
INTRODUCTION
SYNCOPE AND DRIVING
SYNCOPE AND FLYING
SYNCOPE AND SPORTS (SEE ALSO CHAPTER 6)
CHAPTER 6:
Specific Syncope Syndromes
SYNCOPE IN THE PATIENT WITH AN IMPLANTED PACEMAKER OR CARDIOVERTER-DEFIBRILLATOR
SYNCOPE IN CHILDREN
SYNCOPE IN THE ATHLETE
SYNCOPE IN THE ELDERLY
SYNCOPE DUE TO CAROTID HYPERSENSITIVITY SYNDROME
SYNCOPE DUE TO IATROGENIC CAUSES
SITUATIONAL SYNCOPE: DEGLUTITION, DEFECATION, MICTURITION, AND TUSSIVE/COUGH/LAUGHTER
CHAPTER 7:
Vasovagal Syncope
HISTORICAL BACKGROUND
EPIDEMIOLOGY AND CLINICAL PRESENTATION
PATHOPHYSIOLOGY
ROLE OF HEAD-UP TILT TABLE TESTING
TREATMENT OF VASOVAGAL SYNCOPE
TELEOLOGICAL CONSIDERATIONS
CHAPTER 8:
Syncope due to Bradyarrhythmia
INTRODUCTION
CLINICAL PRESENTATION
Sinoatrial Node Dysfunction as Potential Causes of Syncope
Atrioventricular Conduction Abnormality as Potential Causes of Syncope
Treatment of Syncope due to Bradycardia
CHAPTER 9:
Tachyarrhythmia as Cause of Syncope
GENERAL CONSIDERATIONS
CLINICAL PRESENTATION
Approach to Wide QRS Complex Tachycardia: Supraventricular Tachycardia with Aberrancy or Ventricular Tachycardia?
Historical Features
Physical Examination
ECG Findings
Approach to WCT Depending on QRS Morphology in Lead V1
Supraventricular Tachycardia as Cause of Syncope
Ventricular Tachycardia as Cause of Syncope
CHAPTER 10:
Miscellaneous Causes of Syncope
POSTPRANDIAL HYPOTENSION AND SYNCOPE
Clinical Presentation and Evaluation
Pathophysiology
Treatment
PSYCHOGENIC SYNCOPE
HYPERVENTILATION SYNCOPE
POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME
SUBCLAVIAN STEAL SYNDROME AND SYNCOPE
NEUROLOGIC CAUSES OF TRANSIENT LOSS OF CONSCIOUSNESS
METABOLIC/DRUG RELATED CAUSES OF LOSS OF CONSCIOUSNESS
INDEX
TOC
Index
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