Syncope evaluation : Clinical cardiology at it’s new low !

Recently , I came across a   young women  who underwent the following three tests for one episode of syncope after witnessing her pet dog bleeding with  an Injury ! Carotid doppler Holter monitoring and event monitors Brain MRI /MR angiogram This was followed up  by Head up tilt(HUT)  in a premier hospital After 1 week of investigation ,a diagnosis of  Neurocardiogenic syncope was made and she was reassured and no drugs were prescribed. (The collective yield of the above three investigation in fixing  a specific diagnosis is  less than 10 % of all known causes of syncope ) To diagnose  common syncope . . . we need common sense ! Syncope is a dramatic  symptom.It is one of the commonest symptom in ER as well . Life time incidence of syncope is at least one episode in 50% all human life ! The definition  of syncope until recently , was liberal .Any transient loss of consciousness with spontaneous recovery  was termed syncope. This includes Hypoglycemia Anemia Siezure disorders Structural  neurogenic (Including ,  brain tumors , Dural hematomas etc ) Panic attacks (psychogenic) Cardiologists wanted to fix syncope as an exclusive disorder of  circulatory insufficiency.By bringing in a modification in the definition  , ie  syncope is  now defined as a transient loss of consciousness due to   reduction in cerebral perfusion  . This definition helped cardiologists  to exclude the above entities . Still many would include all in single basket as patient s...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: cardaic physiology Cardiology - Clinical Cardiology -guidelines Cardiology -Mechnisms of disease Cardiology -unresolved questions Clinical cardiology general medicine Syncope Tutorial in clinical cardiology event monitors in syncope he Source Type: blogs