Syncope: Mechanisms and Management, 2nd Edition by Blair P. Grubb MD, Brian Olshansky

By Blair P. Grubb MD, Brian Olshansky

Syncope: Mechanisms and administration is the primary textual content and sole resource dedicated to pathophysiological, medical diagnostic and healing info during this box.

The moment version has been thoroughly up-to-date and continues to be the main accomplished and useable reference ever released in this universal scientific entity. it's a ‘must-have’ buy supplying updated assurance of almost each recognized reason for syncope, integrating wisdom of pathophysiology with useful directions for analysis and administration.

This e-book contains new chapters and new info from the difficulty trial, in addition to result of the multi-center trials utilizing equipment remedy in sufferers with syncope and natural center illness. It additionally comprises up to date information regarding the mechanism of neurocardiogenic syncope, carotid-sinus hypersensitive reaction, syncope in adolescence and early life, power fatigue and orthostatic hypotensive problems.

Syncope: Mechanisms and administration is thoughtfully established to make this massive volume of various info effortless to digest – each one part is designed to face by myself whereas additionally being a part of a coherent entire, forming a fantastic origin for extra improvement during this quickly increasing and more and more complicated box.

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Additional info for Syncope: Mechanisms and Management, 2nd Edition

Example text

It should be considered if there is a suggestive history, such as the onset of symptoms with neck compression from position or shaving. An evaluation of the pulses can provide insight into the presence of a dissecting aneurysm or subclavian steal. The carotid impulse may reveal evidence for aortic stenosis but a carotid bruit does not provide a direct cause for syncope. However, it may indicate the presence of other atherosclerotic lesions such as coronary artery disease (cardiac cause for syncope) or subclavian artery occlusion (subclavian steal related syncope).

5 Evaluation of syncope. How often is the cause found by history and physical? ) Patient type Patient Diagnosis History and number “found” physical helped Kapoor [20] Admitted (SUO) 121 13 Day [13] ER 198 173 — 147 Silverstein [200] MICU 108 57 42 Kapoor [14] All comers 204 107 52 Eagle [16] Admitted 100 61 52 Martin [226] ER 170 106 90 History and physical will provide clues to the diagnosis in 30–75% of patients. Diagnosis based on history and physical may be (and often is) inaccurate. ER, emergency room; MICU, medical intensive care unit; SUO, syncope of unknown origin.

Third party payers applied less pressure for discharge during hospitalization as long as a treatment plan was in place, which is appropriate because for hospitalization to be worthwhile, a plan needs to be in place at the time of admission. Unless a new diagnostic assessment plan is established, in one report of 161 patients admitted (Ferrick PACE 1997), 75% did not benefit from admission. Repeated admissions are even less useful. When to consult a specialist Patients often visit primary care physicians, appropriately so, for initial episodes of syncope in an CHAPTER 1 emergency room or in a clinical setting.

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