We're about to see a patient that's reported to have a syncope. Syncope being the transient loss of consciousness
associated with loss of postural tone, postural tone meaning, you know, losing tone of the muscles that keep you up
So essentially he passes out and slumps and we're going to see what this is all about because it can be something very serious
And that's all you remember of it? That's all I remember.
What do you remember next? Her calling me. I thought she pushed me
So you were still in your chair? Yeah. You didn't reach the floor? No.
She grabbed a hold of me. But you weren't flat out on the table either? No. Okay.
What did you witness?
Well, I heard his glass falling and I looked over and he was just slightly going to the left and going down
so I grabbed a hold of his shirt and put him back on his chair
And I just thought he was
maybe his sugars had dropped too low, is what I thought and so I didn't want him to fall on the ground
hard if he didn't have to so that's and as soon as I pulled him up he started pushing himself up. That quickly?
Yeah. So he was only out for..? Two or three seconds
And he was fine. Okay.
Yeah. And his blood sugar was..? I would say 85 at one o'clock and we sat down to eat at one twenty.
So it was right after he had sat down to eat. Did you check it after he passed out?
No, I did check his blood
pressure. Okay. That was 181 over 75
181 over 75. Did you happen to see what his heart rate was? No, I didn't it.
Do you remember any trouble breathing?
No. Okay, you do remember things going black though? Yes. You do recall that occurring? Yes I do.
Okay, let me see what your vital signs were when you came in today
your
blood pressure is 130 over 67, pulse 64, respiratory rate 16
normal temperature. What I'm going to do now is your physical examination
So you have a normal neurologic exam, your cardiovascular exam finds the, um the murmur that's already known
Lung system seems to be clear. I'm not hearing a blockage there or
unusual sounds. We have to look for the cause. Now, the cause could be from something in the heart if
you're not having the heart pump enough blood up, or if there's some kind of a blockage
Um, Neurologic if you're having stroke or TIA
There's also problems with what we call
orthostatic hypotension where somebody will stand up quickly and
the the blood vessels don't squeeze quickly enough to get all the blood up to the brain and so they
essentially stand quicker than the fluid can catch up
And you weren't doing that you were sitting. Oh yeah, I was sitting.
The most common type of
passing out is from what's called Vasovagal or
Neuro Cardiac Syncope
And that's where something stimulates the body in a strange way
to cause the blood vessels to all relax and the blood kind of pools and the the heart can slow too
and that can happen from all sorts of causes and
sometimes associated with swallowing
Go in the bathroom or urinating
coughing. So for you, we need to get the EKG and look for any problems there
But, even if that's completely normal, if we find no other explanation for you passing out,
we're going to ask the cardiologist to do a workup. What we're finding on the EKG is nothing super significant
I do recommend that you not drive until after we've had the workup with cardiologist because
if we can't tell you why it happened? We can't say that it's not going to happen while you're behind the wheel of a car.
Thanks for joining us. We're glad that you were able to learn about syncope.
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if they're interested in medical topics. Until next time this is Dr. Mark Vaughan telling you to stay in good health
Stick your tongue straight out, out like that and back. Let me have your fingers. Is there any numbness on the