Vertigo/Syncope
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Can be encountered as two clinical situations
- A patient himself reporting with a history of giddiness which occurred a few minutes earlier or in the immediate past. Consider
- Syncope
- Vertigo
- Seizure
- Transient ischemic attack (Vertebrobasilar insufficiency)
2. A patient brought comatose with a history of giddiness and fall. Consider
- TIA (vertebrobasilar)
- - Seizure
- – Stroke
- Common Causes of Syncope Vasovagal syncope
- On prolonged standing Postural syncope (syncope on getting up from sitting/lying posture)
- Volume depletion
- Diarrhea/vomiting/blood loss/urinary loss/excessive sweating
- Drugs causing vasodilatation and antihypertensives
- After prolonged bed rest
- Peripheral neuropathy
- Severe anemia Cardiac causes of syncope (Can be postural, exertional or even at rest)
- Arrhythmias
- AV block (Stokes-Adams attacks)
- Acute MI
- AS, HOCM, Primary Pulmonary hypertension (PPH), Pulmonary stenosis (Exertional syncope) Miscellaneous:
- Cough syncope in chronic bronchitis
- Micturition syncope
- Carotid sinus hypersensitivity
- Hypoglycemic episodes
- Hyperventilation syndrome Severe anemia can precipitate postural and exertional syncope