Syncope: Benign vs. Deadly | EM & Acute Care Course
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- Опубликовано: 21 апр 2019
- Syncope: Benign vs. Deadly by Jerome Hoffman, MD
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I’ve been in the ER 10 plus times in my life for passing out - not until 2 years ago did anyone tell me about syncope. I’m so grateful to know that causes me to collapse and sweat and get sick out of nowhere. I’m only 42 - this has happened since I was a teenager.
Can it be corrected?
A great talk! My friend had two fainting spells or syncope in a 3 week time, the last fall (with the faint) he had a laceration on back of his head 9 stables, he was blessed someone saw him fall and called 911, saved his life! He was on Tamsulosin HCL 0.4mg. we stopped the med and no more fainting or synope spells. Dizziness and fainting, side effect of Tamsulsin!
So the alpha blockers are the issue in his case then?
Thanks
Happened to me too
10 staples in my head.?
I don't know what to do, go to hospital and get checked out i guess
That’s why Dr often prescribed Tamsulosin 0.4 mg at Night !!! Bcz it’s common effect is Hypotension (low BP)
Always discuss issues with doc! TC all ❤
A great topic of discussion. I have Bradycardia along with migraine symptoms(Hemiplegic Stroke like ones) that lead to unconscious events,these starting back in May 2022. I was told I have essential tremor but have also been experiencing seizures of unknown causes. A cardiologist who I saw a few years ago told my Gp that I have PR 1st degree heart block with Syncope. I am under the care of many different Specialists. Back and forth trips by ambulance to ED and sometimes nothing is done under than observation with a 12 lead heart monitor,ecg and BP checks as I also have Hypotension problems. I am due to have my first EEG tomorrow. When I do become unconscious though I am often lying down and have had to have CPR done 4 times due to these recurring events. My first Syncope episode was back in 2020 during a vomiting attack reaction to a colon prep medication,so this has been going on for quite some time.My recent hospital trip was rather uneventful after a doctor told me that I looked normal to him and refused to help,I'm glad for my other Specialist team as they are doing all they can to help.
When I passed out at a hospital a few years ago (was accompanying an older friend get an MRI), the medical staff checked my blood sugar (normal), followed by an EKG (also normal, but there was a note by the technician). I'm glad that the doctor whose care I was under did the second test, in keeping with what Dr. Hoffman says here.
Thank you, medical George Carlin 💙
I agree 🤣
one in the same.
I wish George and he had been buds.
DR Jerome Hoffman, MD I LOVE YOU
Would love to have this dr look at my chart..
I cant thank you enough for such helpful and fantastic lecture by dr hoffman .. i wish you upload more videos with neurology related content .. again, thank you 👌
Terrific, thanks for the thought provoking content
Where are you Dr. Hoffman??? Need more lectures
Situational syncope. My pulse is normal all day. Eating and drinking will trigger lightheadedness to almost falling down. I do not passout.. Morning breakfast the worst. Late in the day eating and drinking will cause a lightneadedness but nothing like in the morning . Pulse goes up during these episodes, never down and normal pulse is around 73. Can't find a DR who knows jack about this, I am doing all the discoveries.
Hi, I felt compelled to comment. I'm a nursing student currently conducting a research and teaching project on vasovagal syncope. It sounds like you may be experiencing postprandial hypotension which is an under-recognized cause of syncope. PPH is a drop of systolic blood pressure of more than 20 mmHg within 2 hours of starting a meal and is caused by blood pooling in the splanchnic vascular bed. It is likely to occur in the morning and also after large meals or carb-rich meals. There is an older article from 2004 by AHA on this topic or you can search "Complexity of syncope in elderly people: a comprehensive geriatric approach" by the Hong Kong Medical Journal to learn more. I hope this helps you.
I noticed I had this too after mealtime esp. When it big. Felt like palpitation but it was actually low pulse. Occasionally I get it too when stressed out. I might need to get check for any heart blockage.
Excellent! Cuts to the chase!
This was so enlightening 🙏🥲🤍 Thank you so much for caring about finding those special cases that most doctors continue to overlook because we are “young” and “look healthy” and because they didn’t “catch anything on that ekg that one time” 🙏❤️🩹 Thank you for this. I pray may God help the doctors to truly discover and help me with my heart health issues and syncope, and everyone else out there too 🙏🥺❤️🩹
DR HOFFMAN I LOVE YOU
Very interesting thank you 😊
thank you
Logical and crisp 👍
After i enter our hot tub, i almost always get syncope, i didn't realize it was an issue until i passed out today. I felt sick and foggy headed for half an hour after the few seconds i passed out for.
ACID REFLUX INDUCED SYNCOPE.
If you have bad acid reflux for many weeks or months the lower gullet sphincter seems to stop working so food backs up in the gullet and feels like you cannot swallow or are choking.
Then the pressure of the food causes pressure on the blood vessels from the hart and that reduces blood flow to the brain which suddenly shuts down.
It is quite terrifying when it occured to me three times in ten days.
This sounds similar to situational Syncope/swallowing. Have you checked your blood pressure directly after and then fully recovered?
@@2manycatsforadime It wasn't situational syncope as each time it happened I was leisurely eating small meal at home.
It happened during lockdown and I couldn't get to doctors but got a phone call to one who said he thought I might have throat cancer and arranged endoscopy but it showed everything lovely pink and clean.
The reflux was due to 2 years extreme stress of lockdown and neighbours having tvs blaring from 6am to after midnight.
Worst neighbour died so I got some peace and doctor prescribed Omeprazole that I took for a couple of weeks but now only take every few days when I have been eating baked goods.
Couldn't get blood pressure tested during the syncope period due to lockdown.
So many people take all the antacids advertised on tv instead of altering diet!
@@rosewhite--- Thanks for the reply Rose. I bought a blood pressure cuff from a local big box pharmacy so I could moniter what is going on.
@@2manycatsforadime I didn't think of that as all UK doctors now have selfservice monitors and my pressures are always fine.
Terrifying to me too as I live alone and when it happens it could be on the house tile and hit my head, or while driving. I also have lots of burps and tachycardia.
thanks dr hoffman, briliant as always
This is so good.
I am not sure, syncope needs global lose of blood supply to the brain. A mere loss of blood to thalami is sufficient. Redinbaugh et al. show that, hthe central lateral thalamus has a key role in the control of consciousness, through the modulation of specific corticocortical pathways.
Great video. So how do we treat arrhythmias?
That was exactly what happened to me and the Drs. don’t know why. I felt bad all of the sudden and then I went down.
Simplistic approach. Common-sense approach!
I'm 61 and workout hard still every day. My last 2 chest and back workouts I got syncope bad when I stand up after doing bent over rows and dumbell rows. Like I'm gonna pass out between sets. I can do bench, dumbell presses, flys, pecdeck, lat pulldowns, pull ups, upright rows, lateral raises, flys, and shrugs without syncope. It's only when I raise after doing bent over movements. Very frustrating. I'm gonna go to the VA ER tonight since I have to wait 3 months for a Primary Care Appointment.
Just happened to me tonight, not in the gym but was on the toilet bent over, when i stood up boom sycope grazed my knee pretty bad and my head just missed a sharp cabinet.
Keep us updated!
Doctor advised me to set up ICD, os it required, i have 7 times sycope in last 6 months, but last 1.5 months 4 times. What to say, can i set ICD or I will take medicine???
Could it be heart murmur symptom?
I had my first black out this AM while brewing coffee and slumped over the stove. I have lots of burps and tachycardia. I’m afraid to drive and have another episode. How to avoid another episode?
Lay down, feet above head, wherever you are. Pass a ball back and forth between your hands.squeeze a ball or touch any funny fabric. Keep your focus. Breathe slow and deep. Focus on something. Clench legs in every muscle. Clench hands away from each other. Clench teeth.
If you can't lay down sit down.
Ideally lay down. Don't let anyone around you lift your head up above your body. (Strangers trying to help) writing a note if possible to keep om your personal can help as well. Try to get someone to get you water, and even something with salt. Sugar can help if you feel hungry. Sometimes can not (sugar) help. Focus on something good. Surrender but keep your focus on something. Calm the heart. Release any emotions about anything by crying or pther forms of release. If it's hard to focus, switch your focus around to more than one things, alternating. Be present. Be calm not afraid. Ask /call for help. Search for videos about it. Hope it helps
Call 9-1-1 better safe than sorry.
It's surreal for me.
Omg😮
I have syncope with my heart racing and slowing but doctors say I'm fine. I have severe sweating, sensation to defecate and eventual pass out. But it seems to be stimulated by visual too. Constant eye pain. No epilepsy
I have the same condition and I don’t know what’s to do, best of luck and healing.
@@taylorparker8912 Thank you! I hope you heal also. Don't eat processed foods and no sugar. Get fructose from fruits.
I can sleep on my left side as I have neck artery pain and had syncope
How to prevent?
is there any medicine to cure syncope? Kindly intimate
I don't remember waking up March 25th the day after I had a covid home test spritz me in the eyes(sodium azide). That morning from what I am being told I woke up got dressed and then for some reason had a bath which I don't do, after which I started throwing up profusely and went and laid on my bed to have a convulsion which they describe as a grand mal like seizure. An ambulance came and got me, took me to hospital. While there they said I had another seizure and became violent. They sent me to another hospita(1.5 hrs one way) by ambulance for a CT scan then returned to local hospital and then by about 10pm they called NY wife to come get me. I don't remember anything since the Nighy before. It's been 4 weeks and no more symptoms at all. While at the hospital I also somehow had my t5 and t12 vertebrae fractured. The Dr isn't sure but they are sending me for tests to see if I have epilepsy. I am 50, healthy, I eat right, I don't drink or smoke. I do suffer from extreme pain and depression already. I don't have any other pressure in life. My bills are paid and I own a home.
I am wondering if a seizure can break a healthy person's bones and just come out of the blue. I did have one syncope incident several months previously but woke immediately after 30 to 50 seconds.
Any interesting comments from professionals?
Same with my husband problem 😢 few episodes looks like epilpdy seizure but doctor confirmed that he has no epilepsy..it always triggers when he is standing/sitting on the line long or stress and lack of sleep.Im always scared as a wife.😢
@@naturelove7727
I sympathise as the wife of someone who has had 4 episodes in eight years. All tests seem normal - was prescribed blood pressure medication after the first one and taken off four years later after 3rd episode.
You didn’t mention heart block
He mentioned arrhythmia, and that's what a heart block IS.
I get this and people say its only a faint well l become asystolic then come back after 14 seconds so far
Cut my head falling in itu
What his name ? he have more video?
Hi name is Jerome Hoffman, if you look on RUclips you should be able to find more videos of him.
I have presyncope all day since this morning and I have no idea why, blood pressure fine, sugar levels fine, salt fine, I have no idea what's going on.
Hey! I know I am a year later replying to this comment of yours. However, I identify very much with you! How are you currently?
@@theredshadow360 I'm still fine, symptoms passed by themselves, just get some rest and if you have any chronic, check up on that aswell
Glad to hear you are doing better! And oh boy, I have been through presyncopal episodes for about 3 months already.
No answers and a cardiologist gave up on me too
thankyou
This proposrd methodology, advocating seeking only 3 niche ECG abnormalities (ie) long-QT, WPW & Brugada - each if which is very rare - misses the key, known fact that the majority of maignant ventricular arrhythmias do not occur in these contexts. Rather, they occur in patients with coronary artery disease or left ventricular abnormalities, such as LVH, previous infact scar, impaired LV function etc. These may all manifest on an ECG & therefore should be sought & if present, the patient should be referred for an outpatient echo.
He mentioned that’s for healthy young people only. Anyone with established CAD obviously goes for urgent referral in the episode of syncope
An excellent lecture, criticism to NICE 😂. May I disagree? NICE guidelines aren’t very bad
First we should HUTT test
Long Qt , wpw, afib, vtach ,
True. Most carotid scan are meaningless.
Ectopic pregnancy doesn’t cause hypovolemia, but a ruptured one can.
🙏🙏🙏🙏🙏
He contradicts himsef