Fitzgerald Health Education Associates, Inc.

TABLE 13-1: Syncope, Dizziness & Vertigo

Syncope
• A transient loss of consciousness characterized by a
loss of postural tone, typically sudden in onset with
spontaneous recovery.
Souce- Desai, 2001
Syncope etiology
• Neurally mediated syncope
– Vasovagal syncope
• Fear, pain, anxiety, prolonged standing in one place, warmth,
nausea, sweating, lightheadedness
– Situational syncope
• Cough, defecation, micturition, swallow
• Cardiac outflow tract obstruction
– Structural
• HCM
– Valvular
• Esp. aortic
– Aortic dissection
• Dysrhythmia
– TDP, VT, SVT
• Prolonged QT interval
– AV heart block
• HR< 30 BPM
• Orthostatic hypotension
– Medications implicated in orthostatic syncope
• TCA
• Alpha blockers
• CCB
• ACEI/ ARB
• Clonidine
• Diuretics
85 Flagship Drive VM • 978 • 794 • 8366 email • npr@fhea.com
North Andover, MA 01845-6154 FAX • 978 • 794 • 2455 Internet • http://www.fhea.com
z Page 2 November 7, 2008

• Alcohol
Syncope intervention
• Accurate diagnosis
• Treat underlying cause

Syncope vs. Seizure

Syncope Seizure
<5 mins Often > 5 mins
Injury from fall Usually no injury
No incontinence Incontinence
Normal CK Elevated CK
No warning Aura or prodrome
No disorientation post Post ictal state
episode
Source- Desai, 2001

Dizziness vs. Vertigo

Dizziness Vertigo
Sense of disturbed relationship to Surrounds are moving; with eyes
space, but surroundings are not closed, sensation of motion
moving • “The room is
• “Lightheaded” spinning”
Etiology Etiology
• Multiple cause • Inner ear
Treatment disturbance
• Underlying Treatment
cause • Symptomatic,
underlying
cause
Source- DeGowin & Brown, 2000

85 Flagship Drive VM • 978 • 794 • 8366 email • npr@fhea.com

North Andover, MA 01845-6154 FAX • 978 • 794 • 2455 Internet • http://www.fhea.com
©Fitzgerald Health Education Associates, Inc.