Some patients in our respiratory department have loss of consciousness immediately after severe cough, low body muscle tone, pale complexion, weak pulse, standing may fall, severe facial muscles and extremities twitching, complexion blemishes, etc.; mild patients can be unconsciously lost, After a few seconds to a few minutes, the breathing gradually became regular, and then the consciousness was clear. There was no obvious headache, lethargy, etc. after the attack, and the number of episodes was uncertain. What is that ghost - cough syncope syndrome.
Syncope is common in the clinic. Many diseases can cause syncope. The risk of patients is serious, which seriously affects the quality of life. Distinguishing syncope and clearly diagnosing syncope is of great significance for guiding clinical treatment.
What is syncope? That is, sudden, short-lived loss of consciousness with fainting - sudden cerebral hypoperfusion; the difference with sudden death - can "wake up."
Common classification of syncope
Clinical typical seizure is divided into three phases
1. Aura: The symptoms of autonomic nerves are obvious. Suddenly, the complexion is pale, cold sweat, nausea, upper abdominal discomfort, fatigue, and body swing due to decreased muscle tone. This period lasts only a few seconds.
2, syncope: loss of consciousness and body muscle tension disappeared and fell, pulse breakdown, blood pressure decreased, breathing became shallow, pupil wide, light reflection disappeared, lasted 30 to 40 seconds.
3, recovery period: consciousness self-recovery, gradually awake, still pale, cold sweat, weak body, but unconscious blur and headache, rest for 10 minutes to fully recover, without nerve and physical sequelae.
Four characteristics of syncope symptoms
There are harbingers; rapidity; spontaneous loss of consciousness; self-limiting, complete recovery (difference from sudden death).
1. Identify true syncope and similar syncope;
2, to identify the cause of syncope, establish the relationship between the cause of syncope and sufficient evidence to accurately assess the prognosis of patients and give patients effective treatment;
3. Determine if there are factors that affect death.
Syncope diagnosis plan:
1. Initial examination: detailed patient history, physical examination, ECG, supine and erect blood pressure;
2. Monitoring: Holter, Event, Insertable Loop Recorder (ILR);
3. Improve cardiac imaging, sleep monitoring, etc.
4, special inspection: upright tilt test, hemodynamics, electrophysiological examination, etc.;
The diagnosis of syncope and the clear diagnosis of syncope are of great significance for guiding clinical treatment. Common similar syncope diseases are: sleep disorders, hyperventilation, seizures, acute poisoning (alcohol), hypoglycemia, trauma / concussion, transient ischemic attack, dysfunction (neural pseudo syncope).
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