Syncope - Differential Diagnosis Framework
Reflex Syncope:
• Vasovagal: Prolonged standing, Stress, Pain
• Situational: Coughing, Sneezing, Micturition, Defecation, Post-exercise
• Carotid sinus: hypersensitivity
Orthostatic Syncope:
 • Volume Depletion
 • Medication Effect: a-blockers, antidepressants, antipsychotics
 • Autonomic Failure: Parkinson's, Diabetes, Alcoholism, Amyloidosis, Multiple System Atrophy
Cardiogenic Syncope:
 • Bradyarrhythmias: Sinus bradycardia, Sinus pauses, AV block
 • Tachyarrhythmias: Ventricular
 • Mechanical: Aortic stenosis, HOCM, PE
Syncope Mimics:
 • Seizure
 • "Cerebrovascular Syncope": Vertebrobasilar insufficiency, Subclavian steal syndrome
 • Alcohol "blackout"
 • Sedation
 • Psychogenic pseudosyncope

SCVMC Internal Medicine @SCVMCMed

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