Approach to a patient with syncope:

Ask 3 questions -

Was the LOC sudden or gradual?

Was the regaining of consciousness sudden or gradual?

Is the cardiac exam normal or abnormal?

Neurocardiogenic syncope is interchangeably used for vasovagal syncope which is the most common type of fainting

It is different from pure neurogenic and cardiogenic syncopes.

Neurogenic Syncope

a vasodepressor response caused by a decrease in BP without much change in heart rate. This phenomenon occurs through vasodilation, probably as a result of withdrawal of sympthetic nervous system tone

Cardiogenic Syncope

characterized by a decrease in heart rate -->> decreased cardiac output -->> decrease in BP significant enough to result in a loss of consciousness. It is believed that this response results primarily from enhancement in parasympathetic tone

Micturation Syncope

is a vasovagal syncope that occurs during straining/ micturation

Orthostatic hypotension may occur while getting up from bed walking to the bathroom/ before micturation