Clinical and Electrophysiologic Management of Syncope, An Issue of Cardiology Clinics

Name: Clinical and Electrophysiologic Management of Syncope, An Issue of Cardiology Clinics
Brand: Elsevier
Price: 71.39 EUR
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Antonio Raviele(Autor*in)

Elsevier (Verlag)

1. Auflage

Erschienen am 27. Oktober 2015

100 Seiten

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978-0-323-39329-4 (ISBN)

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Front Cover
Clinical and Electrophysiologic Management of Syncope
Copyright
Contributors
EDITORIAL BOARD
EDITORS
AUTHORS
Contents
Syncope: Definition, Epidemiology, and Classification
Initial Clinical Evaluation
The Value of Tilt Testing and Autonomic Nervous System Assessment
Value of Ambulatory Electrocardiographic Monitoring in Syncope
Value of EP Study and Other Cardiac Investigations
How to Differentiate Syncope from Seizure
Risk Stratification of Patients Presenting with Transient Loss of Consciousness
Syncope in Children and Adolescents
Syncope in the Older Person
Syncope as a Warning Symptom of Sudden Cardiac Death in Athletes
Syncope in Hereditary Arrhythmogenic Syndromes
Syncope and Idiopathic (Paroxysmal) AV Block
Syncope in Patients with Organic Heart Disease
Syncope and Driving
Therapy for Syncope
The Role of the Syncope Management Unit
CARDIOLOGY CLINICS
FORTHCOMING ISSUES
November 2015
February 2016
May 2016
RECENT ISSUES
May 2015
February 2015
November 2014
Syncope: Definition, Epidemiology, and Classification
Key points
INTRODUCTION
DEFINITION
Transient Loss of Consciousness
Is TLOC Characterized by Rapid Onset and Short Duration?
Recovery
Rule Out Head Trauma and Epilepsy
EPIDEMIOLOGY
CLASSIFICATION
PATHOPHYSIOLOGY
Low CO
Low Peripheral Resistance
SUMMARY
REFERENCES
Initial Clinical Evaluation
Key points
WAS LOC COMPLETE?
DID LOC HAVE RAPID ONSET, SHORT DURATION, AND SPONTANEOUS RECOVERY?
DIAGNOSIS OF THE CAUSE OF TRANSIENT LOC
CLINICAL FINDINGS OF NONSYNCOPAL LOC
Epilepsy
Transient Ischemic Attack
Hypoglycemia
Psychogenic Pseudosyncope
Cataplexy
DIAGNOSIS OF THE CAUSE OF SYNCOPE
Typical Vasovagal Syncope
Situational Syncope
Syncope Caused by Orthostatic Hypotension
CLINICAL FINDINGS THAT ARE ONLY SUGGESTIVE OF A CAUSE OF SYNCOPE
SLEEP SYNCOPE
REFERENCES
The Value of Tilt Testing and Autonomic Nervous System Assessment
Key points
HISTORY
IMPACT OF TILT TESTING
NEGATIVITY TOWARD TILT TESTING
THE PLACE OF TILT TESTING TODAY
AUTONOMIC NERVOUS SYSTEM FUNCTION TESTS
SUMMARY
REFERENCES
Value of Ambulatory Electrocardiographic Monitoring in Syncope
Key points
INTRODUCTION
TECHNICAL ASPECTS, IMPLANTING TECHNIQUE, AND FOLLOW-UP OF ILR
ILRS IN THE DIAGNOSTIC EVALUATION OF TRANSIENT LOSS OF CONSCIOUSNESS
Unexplained Syncope
Difficult Cases of Epilepsy
Unexplained Falls
LIMITATIONS OF ILRS
REFERENCES
Value of EP Study and Other Cardiac Investigations
Key points
INTRODUCTION
IDENTIFICATION OF HIGH-RISK PATIENTS
ELECTROPHYSIOLOGY STUDY
Bradyarrhythmia
Tachyarrhythmia
SUMMARY
REFERENCES
How to Differentiate Syncope from Seizure
Key points
INTRODUCTION
EPILEPTIC SEIZURES
SYNCOPE
CONVULSIVE SYNCOPE
THE ROLE OF THE HISTORY
TILT TESTS FOR QUESTIONABLE EPILEPSY
VIDEO RECORDING
ILR FOR QUESTIONABLE EPILEPSY
HEALTH SERVICES DELIVERY
SUMMARY
REFERENCES
Risk Stratification of Patients Presenting with Transient Loss of Consciousness
Key points
INTRODUCTION
CLASSIFICATION OF SYNCOPE
Reflex Syncope (Also Termed Neurally Mediated Reflex Syncope)
Orthostatic Syncope
Syncope Caused by Cardiac Arrhythmias
Syncope Caused by Structural Cardiac and Cerebrovascular Disease
SYNCOPE MIMICS
DIAGNOSTIC PATHWAY
RISK STRATIFICATION OF PATIENTS WITH SUSPECTED SYNCOPE
Short-term or Immediate Risk
SHORT-TERM HIGH-RISK TLOC/SYNCOPE MARKERS
LONGER-TERM RISK
RISK STRATIFICATION BASED ON CARDIAC VERSUS NONCARDIAC CAUSES OF SYNCOPE
SUMMARY
REFERENCES
Syncope in Children and Adolescents
Key points
INTRODUCTION
HOW IS SYNCOPE DEFINED?
HOW COMMON IS SYNCOPE IN CHILDREN?
HOW IS SYNCOPE CLASSIFIED IN CHILDREN?
Autonomic Syncope
Neurocardiogenic syncope
Dysautonomic syncope
Postural orthostatic tachycardia syndrome
Breath-holding spells
Blood injury phobia
Fainting lark
Cardiac Syncope
Obstructive causes
Hypertrophic cardiomyopathy
Aortic stenosis
Primary pulmonary hypertension
Primary myocardial dysfunction
Arrhythmias as a cause of syncope
Long QT syndrome
Brugada syndrome
Cathocholaminergic polymorphic ventricular tachycardia
Noncardiac Causes of Syncope
HOW IS SYNCOPE EVALUATED IN CHILDREN AND ADOLESCENTS?
Laboratory Studies
Blood tests
Electrocardiogram
Video-assisted recording
Ambulatory ECG monitoring
Head-up tilt table testing
Echocardiogram
Imaging
HOW IS SYNCOPE MANAGED IN CHILDREN?
Education and Reassurance
Physical Countermaneuvers
Paced Breathing
Fluid Therapy
Pharmacologic Treatment
Pacemaker Therapy
Cardioneuroablation
FUTURE PERSPECTIVE
REFERENCES
Syncope in the Older Person
Key points
INTRODUCTION
EPIDEMIOLOGY
PATHOPHYSIOLOGY
Cardiac Causes of Syncope
Neurally Mediated Syncope
MANAGING SYNCOPE IN THE OLDER PATIENT: A CASE-BASED APPROACH
Case Vignette 1: When is a Fall Not a Fall?
Discussion
Case Vignette 2: The Swoon
Discussion
Case Vignette 3: Don't Look Now.
Discussion
RECAPITULATION
SUMMARY
REFERENCES
Syncope as a Warning Symptom of Sudden Cardiac Death in Athletes
Key points
INTRODUCTION
EPIDEMIOLOGY AND CAUSES OF SYNCOPE IN ATHLETES
NEURALLY MEDIATED SYNCOPE
ORTHOSTATIC HYPOTENSION
CARDIOGENIC SYNCOPE IN THE ATHLETE
Hypertrophic Cardiomyopathy
Arrhythmogenic Right Ventricular Cardiomyopathy
Atherosclerotic Coronary Disease
Congenital Coronary Artery Anomaly
Ion Channel Diseases
CLINICAL WORK-UP OF THE ATHLETE WITH SYNCOPE
First Level Exams
Second- and Third-level Examinations
Management
SUMMARY
REFERENCES
Syncope in Hereditary Arrhythmogenic Syndromes
Key points
INTRODUCTION
MEDICAL HISTORY
Family History
Circumstances of Syncope
Symptoms
PHYSICAL EXAMINATION
ELECTROCARDIOGRAM
Long QT Syndrome
Brugada Syndrome
Catecholaminergic Polymorphic Ventricular Tachycardia
Short QT Syndrome
SUMMARY
REFERENCES
Syncope and Idiopathic (Paroxysmal) AV Block
Key points
DIAGNOSIS OF IDIOPATHIC AV BLOCK
DIFFERENTIAL DIAGNOSIS FROM OTHER TYPES OF AV BLOCK
EPIDEMIOLOGY OF SYNCOPE DUE IDIOPATHIC AV BLOCK
PATHOPHYSIOLOGICAL CONSIDERATIONS: THE PURINERGIC PROFILE AND THE ROLE OF ADENOSINE
CLINICAL PERSPECTIVES
REFERENCES
Syncope in Patients with Organic Heart Disease
Key points
INTRODUCTION
ORGANIC HEART DISEASE: WHAT IT IS AND WHAT IT IS NOT
IS ORGANIC HEART DISEASE COMMON IN THE SYNCOPE PATIENT, AND IS IT REASON FOR CONCERN?
SYNCOPE AND DEATH: A TEMPORAL ASSOCIATION
HOW IS SYNCOPE RELATED TO ORGANIC HEART DISEASE? MECHANISMS OF SYNCOPE IN ORGANIC HEART DISEASE
EVALUATION AND SUBSEQUENT MANAGEMENT OF SYNCOPE IN PATIENTS WITH ORGANIC HEART DISEASE
Clinical Assessment: History and Physical
WHAT EVALUATION IS NECESSARY TO RULE OUT A CARDIAC CAUSE FOR HEART DISEASE?
Electrophysiology Testing
Implantable Loop Recorders
APPROACH TO THE SYNCOPE PATIENT WITH ORGANIC HEART DISEASE IN WHOM THE EVALUATION IS NEGATIVE
THE FUTURE OF EVALUATING PATIENTS WITH SYNCOPE
SUMMARY
REFERENCES
Syncope and Driving
Key points
INTRODUCTION
FITNESS TO DRIVE
PATHOPHYSIOLOGIC FEATURES OF SYNCOPE AND DRIVING
PREVALENCE, RECURRENCE, AND PROGNOSIS
CANADIAN CARDIOVASCULAR SOCIETY RISK OF HARM FORMULA
COMMERCIAL DRIVING
ETHICS BEHIND REGULATIONS AND GUIDELINES
CURRENT GUIDELINES AND RECOMMENDATIONS
Canadian Medical Association Driver's Guide: Determining the Medical Fitness to Operate a Motor Vehicle
American Heart Association and the Heart Rhythm Society: Personal and Public Safety Issues Related to Arrhythmias that May ...
Guidelines for the Diagnosis and Management of Syncope (Version 2009): The Task Force for the Diagnosis and Management of S ...
SUMMARY
REFERENCES
Therapy for Syncope
Key points
INTRODUCTION
REFLEX SYNCOPE
General Measures
Water Ingestion
Physical Counterpressure Maneuvers
Tilt Training
Drug Therapy
Cardiac Pacing
SYNCOPE SECONDARY TO ORTHOSTATIC HYPOTENSION
CARDIAC SYNCOPE
SYNCOPE AND BIFASCICULAR BLOCK
REFERENCES
The Role of the Syncope Management Unit
Key points
GENERAL FEATURES OF THE SYNCOPE CARE DELIVERY ORGANIZATION
RATIONALE FOR A SYNCOPE MANAGEMENT UNIT
Syncope: the Challenge
Syncope: a Common Problem
Syncope is Costly
STAKEHOLDERS
SETTINGS
Syncope Management in the ED
Syncope Management
Syncope Management: Outpatient
PROFESSIONAL SKILL MIX FOR THE SMU
ROLE OF SYNCOPE UNIT
Initial Evaluation
CARDIAC IMAGING
PROVOCATIVE TESTING
HEAD-UP TILT TEST
ELECTROCARDIOGRAPHIC MONITORING
INPATIENT TELEMETRY
HOLTER MONITORING
EXTERNAL LOOP RECORDERS
IMPLANTABLE LOOP RECORDERS
EXCLUSION OF OTHER CAUSES FOR TRANSIENT LOSS OF CONSCIOUSNESS
SUMMARY
REFERENCES
Index

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