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Symptoms and Signs – Differential Diagnosis of Blackouts
Cardiovascular (transient reduction blood flow to the brain)
Arrhythmia: bradycardia (heart block), tachycardia
Outflow obstruction: aortic stenosis, HOCM, pulmonary embolism, pulmonary stenosis
Postural hypotension: hypovolaemia, autonomic neuropathy (e.g. diabetes), antihypertensive medication (e.g. ACE inhibitors)
Ml, aortic dissection, any condition that reduced cardiac output
Neurological
Epilepsy, stroke/transient ischaemic attack (TIA) (rarely)
Vasovagal (reflex bradycardia)
Prolonged standing esp. in warm surroundings, emotion
Other causes of vagal overactivity: micturition, cough, carotid sinushypersensitivity (e.g. on shaving the neck or head-turning)
Metabolic: hypoglycaemia
Note: there is no clearcut loss of consciousness in 'drop attacks'
Cardiovascular (transient reduction blood flow to the brain)
Arrhythmia: bradycardia (heart block), tachycardia
Outflow obstruction: aortic stenosis, HOCM, pulmonary embolism, pulmonary stenosis
Postural hypotension: hypovolaemia, autonomic neuropathy (e.g. diabetes), antihypertensive medication (e.g. ACE inhibitors)
Ml, aortic dissection, any condition that reduced cardiac output
Neurological
Epilepsy, stroke/transient ischaemic attack (TIA) (rarely)
Vasovagal (reflex bradycardia)
Prolonged standing esp. in warm surroundings, emotion
Other causes of vagal overactivity: micturition, cough, carotid sinushypersensitivity (e.g. on shaving the neck or head-turning)
Metabolic: hypoglycaemia
Note: there is no clearcut loss of consciousness in 'drop attacks'
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