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So Tel inthe Phoretle. ++ + + » fled beget say He: - 12 eval gyncepe, Vamowapel syaape. > "Gucbha denawrd, chogge | ” “oshoronst frend aot > : _f Poroyy cottoke ‘ootflons Sropatich coud floes 7 iatirk reodilobon , b voracuachiche hee =>) ereéroX pefler. , ee 3 Shroaulghon fo axokd und, 609 “Ah bledller . a ot asta he cheb, . Da ope. of bob olen cline for Ce gig ac they te Lockey goiter, + + teins PMC eer Ect} Vasovagal syncope Provoked fear, pain, anxiety, intense emotion, sight of blood, unpleasant ++ + sights and odors, orthostatic stress + 4 Situational reflex syncope a Pulmonary Cough syncope, wind instrument player's syncope, weightlifter's syncope, © =~ “mess trick"* and “fainting lark," sneeze syncope, airway instrumentation Urogenital Postmicturition syncope, urogenital tract instrumentation, prostatic ++ massage a + + Gastrointestinal ‘Swallow syncope, glossopharyngeal neuralgia, esophageal stimulation, + = + gastrointestinal tract instrumentation, rectal examination, defecation syncope Ss Cardiac ok Bezold-Jarisch reflex, cardiac outflow obstruction Carotid sinus oe Carotid sinus sensitivity, carotid sinus massage +4 Ocular Lo Ocular pressure, ocular examination, ocular surgery tot + + + Ft + + + + + + + + + +Robe» & Profrone [Peggrome Laghthedoey, Ozer] 2D Piptlheo, cooren , Iypercea Moher yung, a Nyoclonnd E rnderday route fake] a oe 4 2 Open pan eyes, alevtotd proved Ce ee i ® ? Pap! oi Hanke . ) Prey fed rodnonce Crock of corde Ove. de fcc’) + ot Fe FH ee ee ee oy pool hen hognce, Com) + Treat ord, a he assurane , fe cohen of vewaiog fer) Os Arverdorge of Prvocotive, Heal, Pla Vole eyorten, peal b fed alt ah + ot FF +o oF + + 2 Boo Beoenedre (courbrcpretuee it froneuverel Co = leg erosive and 1p an 4 ‘Dio ( Fencing’) “u They owe, Ned oP, Id “cenhel bled Joo. Lerdaadel oo a ee ee ee + + + + Wrseevnahicting agent, (2 blocker, Cora [Link]. 7 toys in hich syncape os ossperabe ath, osyudgle LHR, coon sinus syrohen toe oF oF FF Args t Pldvocorbtixae 0, + Oy tset 7 BOR RR RR Foe HR RRR RH HR ROR HH RR RR RG toh RR RR RR HR RR HR RR RR| BO ebbashads bysrhosie, 7 Pel yp > Aecrcted) Sap. 200 anny < or up 2fo-mony + win zm fotoly a hid ie 2 Lee 4 “synpebcde hoor flee. . oo Dempe false, 9 Behl ae LOM sommpensetngy PinYR Same cogre tf Fin we. + oF bot toe FoF tH RH HOR 4 oH FOF HE HE OG Fattoce ob atone gynpthebe farloce > phyenhgreal Vatocone fie- thea ea. efendhae cs repiiced 2 VBP ciolohe > | serobeaf Aeloyes! Peskiroll ® “yah: oo Porte Pood by nna = OP Bile 4 fee 3 an “s Sti Boop see “ohode, * + ot te oR ee + oe et et Ropram? Fale pryptoete . ~ Donwd” refer! auhowne fartare Se | Gefoetn on 8 Gf Cuned abe & mcmmdoh befF toe + SSS BSD Bylh Cpéapheual bot toe OR RR RRR HR HR eye Re ss ty a rr L Light headrest, Rroanes , Aesynope a bot ob ae 2 Visual Shaving , reek 9079 , orbosdadc Sypres. oneraa Ca a v +» Aueh occipital veoh? ay, vookiralazped me tt tt = 5 Shenoca—. peace aarp s Ascherora tO OR RR RR HR RR HR RR RR 2 Supie Yysedinin “che dy Seshreoil, dgocinay ~~ * *+ 4 4 SET + Prinay + + + neurodegene + + Lewy body diseases ne Parkinson's disease “8 ae Lewy body dementia Lok Pure autonomic failure ee ‘Multiple system atrophy (Shy-Drager syndrome) ok Secondary autonomic failure due to autonomic peripheral neuropathies toot Diabetes toe Hereditary amyloidosis famil ee Primary amyloidosis (AL amyloidosis; immunoglobulin light chain oe associated) wes Hereditary sensory and autonomic neuropathies (HSAN) (especially se type lIl—familial dysautonomia) we Idiopathic immune-mediated autonomic neuropathy se Co Autoimmune autonomic ganglionopathy a Sjogren's syndrome Co Paraneoplastic autonomic neuropathy a HIV neuropathy + oF oF Postprandial hypotension a latrogenic (drug-induced) ee Volume depletion + + Creohren!, f Revewe. ravecsible “outer usually vwovedve vredhcadvy, 2 Mor, phormacolgre, inrbarcathes Obert coke catia, | + oF + oF to HE :loacang obout legge oe. “Kowne, bed vod, of bed, Kevan hee a whepremere | Moneu ers “to rane Ap + to + toe oe oF FoF HR HoH FF HF HH eG \Pemtotgie | + Pladpacorhseo é Vorscsarhindyg grad < peeudoaphedrme, eS aCoe Secure A, ohuchoal tert free : + + + + . + Arrhythmias - Sinus node dysfunction ~ Atrioventricular dysfunction . Supraventricular tachycardias <200 HB 3M syncage. . Ventieulrtechyerias — Fs p6y 1 > cy renpe ~ Inherited channelopathies + Cardiac structural disease . Valvular disease Myocardial ischemia ~ + Obstructive and other cardiomyopathies + Atrial myxoma . Pericardial effusions and tamponade *sHyperventilation for ~1 min, followed by sudden chest compression ~ _, Hyperventilation (~20 breaths) in a squatting position, rapid rise to standing, then =, Valsalva maneuver. tO FH RR HR RR RR HR RR caterad 826 gode Ayefochen | Ore dycondn >. onde “A Vv Sysfon san Pr > + SY, fachyeortos, Ss .oblitien Ventionder fachycordn ia Aug, pl eebe ee a eR EE . BC Ofoaobal me Bk Avec! zed oe ported Seine Co Ce toe oR 4 + 4+ ot oR + Vietbuler, Dugarcderr, ceabeton chysfrchon, Gort dfsordee Wad ey Ao HM + Bycchad tre, ee) ows ob Noro Affe Sei ; Serue LY, (Dpoolonrz poovement 7 $e, chore, movement Bok ee Pe , Aura Compewally 5). Payee Oudey veual ‘olluctm bun +o oF toe tH RR H+ tot HR HR Re ee Le RHR RR SZ Loc >Smin Eroreediale seoqvery. OR HE fe a ee ee toe oR FF 4 Muscle oche severe Ling |, Drof + + F ee . Ss Peal meond ont COM> Bore ROM, {OE OVE apayer i YOR ~ Frere, po 0dobva , ormedy No Auoger hunger, presthesa Aug fo _ whavene actvedan fo coo tel, Jing oluce a ibeolag, Oo Proliag) > ee “one of, porbel o congplede lore of enrack done . Anger by. steag ern fon, Mea Peger or (ougleter Co a > Qosec -Qrdin POSS BQ. toe eR + FF FH FH + tO OR RR RRR HR RR HR RR RR + toe RR RR RR RR Pychrabre. a: rarer . 2 oon roreher geroebel, we he ? Puthyy tod ‘predaee prepay. falaaton. © in 4 yeot Hoomus) ee fy 4 Posbel lewsessroenf a vs iy Bite os Co 5H cy Felt fable tareg Co Aedroonsre nerves wy bra Aah C capohe!l enoscaging ede, BPraigysplihe °C aavin cath dap mepieheT .° “gop Con Juke Wrervocog ody gored raporte> . “4g Otrroe eet eG Bm a 7 aks +9 Corde Balaton SO LL, a . Efocodigorphy Heltac & Les recarder ++ ++ + + + + + + oF + 4 ob oF be HE Hee Me cine ntti ae + + + Be arated + + Cardiac syncope Neurocardiogenic Seizures toe F bo + Premonitory Often none Delirium ee symptoms —Lightheadedness —Lightheadedness_-—-Hyperexcitability | © = Palpitation Olfactory ee Chest pain hallucinations eee Breathlessness ‘Aura’ toe oF oe + Unconscious — Extreme ‘death- Prolonged 4 | period like’ pallor (1 min) Be unconsciousness toe oF Motor seizure |, actvity* Bk Tongue-biting =|. Urinary oe incontinence ne Recovery Rapid (< 1 min) Prolonged Foe Flushing delirium FoF Lightheadedness (> 5mins) toe F Headache oe + Focal Foe neurological FoF signs toe F bo + *N.B. Cardiac syncope can also cause convulsions by inducing cerebral anoxia. toe oF toe + toe F + + CO ene acy toe oF + + Seizure Syncope + + + | Aura (e.g. olfactory) + - toe + t+ oF + Cyanosis, + = t+ oF + Lateral tongue-biting + an * © © | post-ictal detirium + - nn . «4 | Post-ictal amnesia + - oe Post-ictal headache = + - toe oF +o + Rapid recovery - + +o ob oF FFF FF + yee HOH+4 Fig. 94 The diferental diagnosis of syncope and presyncope, + toe RR RR RR HR RR HR RR RR . 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LS Bram - Blacose cleprir ation + 9", $O PATO og + + > Bran dopents alent cobrely on Qlucose fo cnugy. ty t yt, ty tt te hen blol pluose 5. to © Laaoneh AOD peocbschor* a a toe FR RF RF0 Repeied szoaphe troowmasyon, Cochool, dafarchun tote Prs leacly 4g eee + + a a + + + toe FR RR H+ + oe oF 4 4 Sek Fk RR EE 2 Corebral roansdichun in tevee coset. RO OMSL LEE ASL. + + Wpnthadaen. Curr wpten, cvafed + 2 Ahen blook plugne, bop, counter - regalodngy. elevated, by adrenoline ond, 20g -odenahive + + + + + + + + Thete b tM ek ek cotechalormes 44 4 “p J Pscee reptadey dave, . hyd, oha Mors Sreathing + Syper verdtoney + v Aeppiodey oftalpso. Obed cm toe A eR : Bese Qi . + oF 4 toe Pe ek Corebe) arhrtyle meg cle BO L 4 oe ee eR & coebad blood fo? eee + 44 4 to 4 24 Pregyn toe FR RR HF toe FR RR H+ + + + + + + + + + gons v boat boat respoase ep!oat i oo J 1D Teo ECG, 1. esseodid in abl pohert a hy “of. eshblchiag obop neces I, | he o bhin, C4 rons while syroptras Pe Present. / . 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