Syncope DDx

Syncope – Differential Diagnosis

Common causes

• Vasovagal syncope
• Orthostatic hypotension
• Anxiety/ Hyperventilation

Must Not Miss

• Hypovolaemic shock
• Septicaemia
• Vascular
  • CVA / TIA
  • Arrhythmia
  • Myocardial Infarction
  • Aortic stenosis
  • Pulmonary embolism
• Ectopic pregnancy
• Hypoglycaemia
• Seizure/ SOL

Easily missed

• Medications
• Drugs& Alcohol
• Obstructive sleep apnoea
• Anaemia
• Addison’s disease

Red flags

• Chest pain/palpitations
• Dyspnoea
• Prolonged unconsciousness
• Confusion
• Neurological deficit
• Headache
• Vomiting
• Drug & Alcohol misuse
• Positive pregnancy test

Investigations to consider

• FBC, D-dimers
• U&Es, Bone profile, Serum glucose
• Pregnancy test
• Troponin/cardiac enzymes
• ECG
• 24 hour ECG
• Echocardiography
• EEG
• CT/MRI scan (head)
• V/Q scan
• Tilt table testing