Ch.5 Syncope

This flashcard set covers the essential vocabulary, etiologies, signs, and treatments of Syncope based on the dental emergency lecture materials.

Syncope

An abrupt, transient loss of consciousness (TLoC) and postural tone with spontaneous recovery. Often associated with a medical condition.

Syncope effects

children, pregnant mothers, and elderly

syncope in children

missed meal, heat, dehydration, crying, exertional activity

syncope in elderly

postural changes for example Orthostaic hypotension, defecation, coughing, medications, coronary heart disease

Cerebral Ischemia

A loss of cerebral oxygenation and perfusion that often causes syncope.

Vasovagal Syncope

The most common form of syncope, responsible for $66\%$ of all ER visits related to the condition and common in dental offices. Occur during local anesthesia.

Orthostatic Hypotension

Also known as postural hypotension; it is a drop in blood pressure with sudden movements, defined as at least a $20\,mmHg$ drop in systolic or a $10\,mmHg$ drop in diastolic blood pressure upon assuming an upright position.

Neurocardiac Syncope

Also known as vasodepressor, vasovagal, or neurocardiogenic syncope; it is associated with noxious stimuli such as pain, fear, or exhaustion.

Noxious Stimuli

Stimuli that are harmful or injurious to health, such as pain, fear, exhaustion, or illness.

Catecholamines

Substances like epinephrine and norepinephrine released by the sympathetic division to muscle tissues in preparation for movement.

Noncardiac Syncope

Reduction of BP. Syncope caused by factors other than cardiac issues, including seizures, orthostatic hypotension, situational occurrences, hyperventilation, or metabolic diseases.

Situational Occurrences

Triggers for noncardiac syncope, such as coughing, urination, defecation, neck stretching, hair grooming, venipuncture, and swallowing.

Valsalva Maneuver

A forced expiratory effort against a closed airway, occurring when an individual holds their breath and tightens muscles in a strenuous effort.

Hyperventilation

Excessive breathing that changes the chemical makeup of blood, potentially causing cerebral vasoconstriction and syncope.

Hypoglycemia

Low blood sugar, which is a metabolic cause of noncardiac syncope.

Hypoxemia

Low oxygen in the blood, which is a metabolic cause of noncardiac syncope.

Cardiac Syncope

A potentially fatal loss of consciousness due to inadequate cardiac output, usually from underlying heart disease like arrhythmias or obstructions. Requires referral to a cardiologist for further evaluation and management.

Presyncope

The early stage of syncope characterized by pallor, pupil dilation, diaphoresis, and a slow onset of symptoms. Weakness, dizziness, nausea, yawning, vision changes, increased BP, shortness of breath, heart palpitation, chest pain, slow onset

Pallor

A pale appearance, often occurring as a sign of presyncope.

Diaphoresis

The medical term for sweating, frequently observed as a symptom of presyncope.

Piloerection

The contraction of piloerector muscles causing hairs to stand on end, commonly known as goose bumps.

Supine Position

The recommended position for treating a patient in syncope, which involves lying flat with the legs slightly elevated.

treatment

objects removed from oral cavity, position supine, open airway, assess circulation, loosen tight clothing, administration of oxygen, 4-6 liters/minute, monitor vital signs

Sympathetic Nervous System (Heart)

The division of the autonomic nervous system that increases heart rate and contractile force and vasodilates coronary arteries.

Parasympathetic Nervous System (Lungs)

The division of the autonomic nervous system that causes bronchoconstriction.

Sympathetic Nervous System (Eyes)

The division of the autonomic nervous system that causes pupil dilation.

Syncope is the sudden loss of consciousness and postural tone, and is most often caused by a loss of cerebral oxygenation.

Both phrases are true.

Which age groups are particularly susceptible to syncope?

geriatric individuals

All of the following are common classifications of syncope except one. Which one is the exception?

obstructive syncope

The most serious form of syncope is

Cardiac

Hyperventilation can cause syncope due to

cerebral vasoconstriction

The symptoms associated with syncope stem from the stimulation of the

parasympathetic nervous system

All of the following are signs or symptoms associated with syncope except one. Which one is the exception?

pupil constriction

In what position should a patient be placed when suffering from syncope?

supine with feet elevated