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Solving the Puzzle of Syncope Part. 2

September 30, 2017


High Yield Review - Syncope + Trigger + Prodrome 

Case: A 21 y/o female accompanied by her boyfriend and mother. Today while she was standing in line for the newest smart phone, she started to feel a warm sensation and abdominal pain, she then passes out, her boyfriend breaks her fall and he lays her down flat, she briefly lost consciousness and then

came to, she was not confused afterwards. 


While getting her blood drawn the needle causes her pain and she faints again. 


Her boyfriend sees the blood fill the tube and starts to 

feel nauseated and has a pallor appearance and then he briefly loses consciousness, with some jerking movements seen. 


At this time her mother in the waiting room who has had a cold recently has  fits of coughs/ sneezes and also faints. 


Case Clues - Vasovagal Syncope

- The 21 y/o female was standing in line when she had her first syncopal event, this trigger is orthostatic hypotension,  This improved  in the supine position and was brief, she had no confusion after. Her 2nd syncopal event occurred at venipuncture this trigger is painful stimuli. Her prodrome of symptoms were abdominal pain and  warm sensation. 


- Her boyfriend saw the sight of  blood and this is an emotional trigger that caused his syncopal event, brief tonic clonic movements seen which is convulsive syncope. His prodromal symptoms were pallor and nausea. 


- Her mother had cough and sneezing fits and this was trigger to her situational syncope. 



Know it for the Boards - Vasovagal Syncope!





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