Syncope And Dizziness

It is uncommon for dizziness to be caused by cardiac disease. However, loss of consciousness (syncope) or the feeling of impending loss of consciousness (presyncope) may be cardiac in origin. The causes can be broadly classified into three groups left ventricular outflow obstruction. Drug related Some of the drugs which may cause palpitations may also produce syncope or presyncope (Table 3.2). Vasodilator drugs (e.g. alpha-biockers) can cause symptomatic postural hypotension. Beta-blockers,...

Fits Faints And Funny Turns

The terms 'blackout', dizziness and 'funny turn' are commonly used to describe the sudden onset of an altered state of consciousness. Such episodes may denote any of the following symptoms Vertigo a sensation of unsteadiness and loss of balance associated with a feeling of rotational movement due to dysfunction of the vestibular syslem of either a central or peripheral origin. Syncope lightheadedness or faintness associated with the feeling of impending and or actual loss of consciousness due...

Vertigo

The vestibular system includes the peripheral vestibular TABLE 6.4 Patterns of vertigo and ttieir causes apparatus of the inner ear and vestibular nerve, the central connections of the vestibular nuclei within the brain stern and their cortical projections to the temporal lobes. Any disorder which disrupts the balance of the two vestibular inputs may produce vertigo of varying severity from a 'swimming sensation in the head to severe hallucinations of rotational movement with nausea and...

Contributory factors

The complaint of shortness of breath dyspnoea indicates a conscious appreciation of increased work done during breathing and is a natural consequence of strenuous physical exercise. The principal factors contributing to the production of breathlessness are a an increase in the work of breathing, b increased ventilatory drive and c impaired respiratory muscle function. Each has a variety of causes. Several factors may operate in an individual patient to produce breathlessness. The clinical...

Common abnormalities

If impaired hearing is unilateral it should be determined whether it is either conductive i.e. due to disease of the tympanic membrane or ossicular chain or sensorineural e.g. involving the organ of Corti or the cochlear nerve in origin. If bone conduction is better than air conduction in Rhine's test this indicates a conductive defect. In Weber's test, a patient with sensorineural deafness will perceive the sound as arising from the better ear. In conduction deafness. however, the sound...

Cardinal symptoms

Patients with heart disease may be asymptomatic. Their cardiac pathology may be diagnosed during 'routine' examination or because of the development of a complication e.g. atrial fibrillation in mitral stenosis . I lowever, the cardinal symptoms of heart disease are chest discomfort, hreathlessness, palpitations, syncope and peripheral oedema. None of these symptoms indicate that heart disease is definitely present because they are not specific see Table Angina Pericarditis Aortic dissection...

Differential diagnosis of syncope and epilepsy

Alcohol And Blackouts

Most blackouts are due to either syncope or epilepsy. Patients who fall to the ground may attribute the episode to a trip those who are unable to recall hitting the ground have usually lost consciousness before falling. The diagnosis of blackouts is most readily made if a Lrained observer witnesses an episode. Every effort should be made to interview any available eyewitness. Prodromal features. Nausea, visual dimming and a sense of impending loss ot'consciousness precipitated by prolonged...