Altered Mental Status & Syncope

last updated: September 15, 2016

Orlando Debesa

Syncope

  • Hypoxia (hypoglycemia does not cause syncope)

  • Epilepsy (not a true cause of syncope)

  • Anxiety and hyperventilation

  • Dysfunctional brain stem (basivertebral TIA)

  • Heart attack (ACS)

  • Embolism (PE)

  • Aortic obstruction (IHSS, AS or myxoma)

  • Rhythm disturbance, ventricular

  • Tachycardia

  • Vasovagal (emotional reactions) or Valsalva (micturition, cough, straining etc)

  • Ectopic (and other causes of hypovolemia)

  • Situational

  • Subclavian steal

  • ENT (glossopharyngeal neuralgia)

  • Low systemic vascular resistance

  • autononic dysfunction: Addison’s, diabetic vascular neuropathy

  • Drugs such as CCBs, beta-blockers, anti-hypertensives

  • Sensitive carotid sinus

Altere Mental Status

  • A: Acidosis

  • E: Electrolytes

  • I: Infection

  • O: Opiates 

  • U: Uremia

  • S: Sugar

  • T: Trauma

  • I: Insulin

  • P: Poisoning/Psychosis

  • S: Stroke/syncope

  • T: Thyroid

  • O: Overdose

  • E: Encephalopathy

  • S: Seizure

... but I would more especially commend the clinician who, in acute diseases, by which the bulk of mankind are cutoff, conducts the treatment better than others.
 
Hippocrates, 400 BC