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Cardiovascular Emergencies

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Family Medicine

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Abstract

Syncope, defined as a sudden temporary loss of consciousness not caused by head trauma or a seizure, has many causes.1,2 Patients who suffer a syncopal episode should not require chemical or electrical cardioversion to regain consciousness. Syncope accounts for approximately 1% to 6% of hospital admissions and 3% of emergency room visits.3,4 The occurrence of syncope in the 26-year surveillance of the Framingham Study is 3.0% among men and 3.5% among women.5 There is little information regarding the incidence of syncope in the pediatric population. Similarly, the epidemiology of syncope in the general elderly population is not well studied. A yearly incidence of 6% and a recurrence rate of 30% was found in a 2-year prospective study.6 True syncope occurs much less often than symptoms that suggest near-syncope, which are usually described as light-headedness or dizziness.

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References

  1. Kapoor WN. Evaluation and management of the patient with syncope. JAMA 1992;268:2553.

    Article  PubMed  CAS  Google Scholar 

  2. Benditt DG, Temole S, Milstein S, et al. Syncope: causes, clinical evaluation, and current therapy. Annu Rev Med 1992;43:283.

    Article  PubMed  CAS  Google Scholar 

  3. Day SC, Cook EF, Funkenstein H, Goldman L. Evaluation and outcome of emergency room patients with transient loss of consciousness. Am J Med 1982;73:15–23.

    Article  PubMed  CAS  Google Scholar 

  4. Gendelman HE, Linzer M, Gabelman M, Smoller S, Scheuer J. Syncope in a general hospital patient population. NY State I Med 1983;83:1161–5.

    CAS  Google Scholar 

  5. Savage DD, Corwin L, McGee DL, Kannel WB, Wolf PA. Epidemiologic features of isolated syncope: the Framingham study. Stroke 1985;16:626–9.

    Article  PubMed  CAS  Google Scholar 

  6. Lipsitz LA, Wei JY, Rowe JW. Syncope in an elderly institutionalized population: prevalence, incidence, and associated risk. Q J Med 1985;55:45–55.

    PubMed  CAS  Google Scholar 

  7. Lewis RP, Schaal SF, Budoulas H, Weissler AM. Diagnosis and management of syncope. In: Schlant RC, Alexander RW, editors. The Heart, 8th ed. New York: McGraw-Hill, 1994:907–25.

    Google Scholar 

  8. Hancock EW. Syncope. Sci Am 1995;1–7.

    Google Scholar 

  9. Dickinson CJ. Fainting precipitated by collapse-firing of venous baroreceptors. Lancet 1993;342:970.

    Article  PubMed  CAS  Google Scholar 

  10. Rea RF, Thames MD. Neural control mechanisms and vasovagal syncope. J Cardiovasc Electrophysiol 1993;4:587.

    Article  PubMed  CAS  Google Scholar 

  11. Bousser MG, Dubois B, Castaigne P Transient loss of consciousness in ischemic cerebral events: a study of 557 ischemic strokes and transient ischemic attacks. Ann Med Intern 1980;132:300–7.

    Google Scholar 

  12. Huang SK, Erzi MD, Hauser RG, Davis P. Carotid sinus hypersensitivity in patients with unexplained syncope: clinical, electrophysiological, and long-term follow-up observations. Am Heart J 1988;116:989–96.

    Article  PubMed  CAS  Google Scholar 

  13. Greech ED, Ramsdale DR. Exertional syncope in aortic stenosis: evidence to support inappropriate left ventricular baroreceptor response. Am Heart J 1991;121:603–6.

    Article  Google Scholar 

  14. Nenaber CA, Hiller S, Speilmann RP, Geiger M, Kuck KH. Syncope in hypertrophic cardiomyopathy: multivariate analysis of prognostic determinants. J Am Coll Cardiol 1990;15:948–55.

    Article  Google Scholar 

  15. Atkins D, Hanusa B, Sefcik T, Kapoor W. Syncope and orthostatic hypotension. Am J Med 1991;91:179–85.

    Article  PubMed  CAS  Google Scholar 

  16. Strasberg B, Sagie A, Erdman S, Kuniec J, Sclarvosky S, Agmon J. Carotid sinus hypersensitivity and the carotid sinus syndrome. Prog Cardiovasc Dis 1989;5:379–91.

    Article  Google Scholar 

  17. Kapoor WN. Workup and management of patients with syncope. Contemp Issues Cardiol 1995;79:1153–70.

    CAS  Google Scholar 

  18. Krol RB, Morady F, Flaker GC, et al. Electrophysiologic testing in patients with unexplained syncope: clinical and noninvasive predictors of outcome. J Am Coll Cardiol 1987; 10:358–63.

    Article  PubMed  CAS  Google Scholar 

  19. Lacroix D, Dubuc M, Kus T, Savard P, Shenasa M, Nadeau R. Evaluation of arrhythmic causes of syncope: correlation between Holter monitoring, electrophysiologic testing, and body surface potential mapping. Am Heart J 1991;122: 1346–54.

    Article  PubMed  CAS  Google Scholar 

  20. Thilenius OG, Quinones JA, Husayni TS, Novak J. Tilt test for diagnosis of unexplained syncope in pediatric patients. Pediatrics 1991;87:334–8.

    PubMed  CAS  Google Scholar 

  21. Kapoor W. Evaluation and outcome of patients with syncope. Medicine (Baltimore) 1990;69:160–75.

    CAS  Google Scholar 

  22. Bannister SR, editor. Autonomic failure: a textbook of clinical disorders of the autonomic nervous system. 2nd ed. London: Oxford University Press, 1988:1–20.

    Google Scholar 

  23. Norman LG. Medical aspects of road safety. Lancet 1960;1: 989–94,1039–45.

    Article  PubMed  CAS  Google Scholar 

  24. Brennan JF, Davies A, MacDonald RG, et al. Assessment of the cardiac patient for fitness to drive. Can J Cardiol 1992; 8:406–11.

    Google Scholar 

  25. Sheldon RS, Rose S, Flanagan P, Koshman ML, Kilan S. Multivariate predictors of syncope recurrence in drug-free patients following a positive tilt table test (abstract). Circulation 1994;90 Suppl I:55.

    Google Scholar 

  26. Hinshaw LB, Cox BG. The fundamental mechanisms of shock. New York: Plenum, 1972:13.

    Book  Google Scholar 

  27. Weil MH, Shubin H. The “VIP” approach to the bedside management of shock. JAMA 1969;207:337.

    Article  PubMed  CAS  Google Scholar 

  28. Reddy GV, Schamroth L. The electrocardiology of right ventricular myocardial infarction. Chest 1986;90:756–60.

    Article  PubMed  CAS  Google Scholar 

  29. Doukas DJ, McCullough LB. The values history: the evaluation of the patient’s values and advance directives. J Fam Pract 1991;32:145–53.

    PubMed  CAS  Google Scholar 

  30. Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA 1960;173:1064–7.

    Article  PubMed  CAS  Google Scholar 

  31. Cummins RO, editor. Textbook of advanced cardiac life support. 1994:1–4.

    Google Scholar 

  32. Ruskin JN, McGovern B, Garan H. Sudden death. In: Stein JH, editor-in-chief. Internal medicine. 4th ed. St. Louis: Mosby, 1994:143–9.

    Google Scholar 

  33. Murphy DJ, Murray AM, Robinson BE, Campion EW. Outcomes of cardiopulmonary resuscitation in the elderly. N Engl J Med 1989;111:199–205.

    CAS  Google Scholar 

  34. Russel S, Wenger NK, Teno J. Choices of seriously ill patients about cardiopulmonary resuscitation: correlates and outcomes. Am J Med 1996;100:128–37.

    Article  Google Scholar 

  35. Asch DA, Hansen-Flaschen J, Lanken PN . Decisions to limit or continue life-sustaining treatment by critical care physicians in the United States: conflicts between physicians’ practices and patients’ wishes. Am J Respir Crit Care Med 1995;151:288–92.

    Article  PubMed  CAS  Google Scholar 

  36. Levy DE, Caronna JJ, Singer BH, Lapinski RH, Frydman H, Plum F. Predicting outcome from hypoxic-ischemic coma. JAMA 1985;253:1420–6.

    Article  PubMed  CAS  Google Scholar 

  37. Lanken PN, Ad Hoc Committee of the Section of Critical Care; American Thoracic Society (ATS) Bioethics Task Force. Withholding and withdrawing life-sustaining therapy. Am Rev Respir Dis 1991;144:727–32.

    Article  Google Scholar 

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Authors
  1. David C. MacDonald
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Editor information

Editors and Affiliations

  1. Department of Family Medicine, Oregon Health Sciences University, Portland, OR, 97201, USA

    Robert B. Taylor M.D. (Professor and Chairman) (Professor and Chairman)

  2. Department of Family Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA

    Alan K. David M.D. (The Fred Lazarus, Jr., Professor and Director) (The Fred Lazarus, Jr., Professor and Director)

  3. Department of Family Medicine, St. John’s Mercy Medical Center, St. Louis, MO, 63141, USA

    Thomas A. Johnson Jr. M.D. (Chairman) (Chairman)

  4. Department of Family Medicine, University of Mississippi School of Medicine, Jackson, MS, 39216, USA

    D. Melessa Phillips M.D. (Professor and Chairman) (Professor and Chairman)

  5. Department of Family Medicine, University of California—Irvine College of Medicine, Orange, CA, 92697, USA

    Joseph E. Scherger M.D., M.P.H. (Associate Dean for Primary Care and Chair) (Associate Dean for Primary Care and Chair)

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© 1998 Springer Science+Business Media New York

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MacDonald, D.C. (1998). Cardiovascular Emergencies. In: Taylor, R.B., David, A.K., Johnson, T.A., Phillips, D.M., Scherger, J.E. (eds) Family Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2947-4_80

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  • DOI: https://doi.org/10.1007/978-1-4757-2947-4_80

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-2949-8

  • Online ISBN: 978-1-4757-2947-4

  • eBook Packages: Springer Book Archive

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