⚕️ FREE MSRA PODCAST – Syncope
🎧 A high-yield breakdown of this brief loss of consciousness condition – perfect for exams and real-life clinical practice.

🧠 Key Learning Points

📌 Definition
• Syncope is a sudden, short-lived loss of consciousness due to transient cerebral hypoperfusion, with rapid, full recovery.

📌 Causes & Risk Factors
• 🧠 Neurally mediated syncope (vasovagal, situational, orthostatic)
• ❤️ Cardiac causes (arrhythmias, structural heart disease)
• 🩺 Mixed/other: pulmonary embolism, stroke, hypoglycaemia, drugs
• 👵 More common in teenagers and older adults
• 💊 Risk ↑ with diuretics, antihypertensives
• 💡 Mnemonic: "PUMP, PIPES, or CONTROL" = Cardiac, Vasodilation, Autonomic

📌 Pathophysiology
• 🔻 Drop in BP or HR → cerebral hypoperfusion
• 🔁 Disruption in autonomic regulation or cardiac output
• 💥 Rapid but reversible ‘power cut’ to the brain

📌 Symptoms
• 😵 Dizziness, nausea, sweating, visual blurring
• 🥴 “Blackout” followed by rapid recovery
• 🔍 Warning signs (prodrome) help differentiate from seizures
• 🧠 Duration usually seconds (longer = consider pseudoseizure)

📌 Differential Diagnosis
• ⚡ Seizure (postictal confusion, tongue bite)
• 🧪 Hypoglycaemia
• 🌪️ Vertigo
• 🤯 Pseudosyncope
• 👨‍⚕️ Drop attacks, TIAs, substance misuse

📌 Diagnosis
• 📖 History + witness account = 🥇most important
• 🩺 Orthostatic BP
• 📉 ECG (arrhythmias, QT changes)
• 🩸 FBC, glucose
• 🪑 Tilt table test for suspected NMS
• 🫀 Echocardiogram, Holter/event monitoring if cardiac cause suspected

📌 Management
• 🔁 Depends on the underlying cause
• 🧘‍♀️ NMS: reassurance, trigger avoidance, hydration, isometric manoeuvres
• 🧦 Compression stockings, raise bed head, salt intake
• 💊 Fludrocortisone/midodrine (caution: limited evidence)
• ❤️ Cardiac: pacemaker, ICD, ablation, surgery as required
• 🚗 DVLA: 3P rule (Provoked, Prodrome, Posture) determines driving eligibility

📌 Complications
• 🤕 Injuries from falls
• 🧠 Anxiety and impaired QoL from recurrent episodes
• ⚠️ Red flags: Abnormal ECG, Age >45, Ventricular arrhythmia Hx → ↑ mortality risk

📌 Prognosis
• 🟢 NMS often benign
• 🔴 Cardiac syncope → high risk → prompt treatment essential
• 📈 Risk stratification vital to guide workup and management

📎 More MSRA Resources for Syncope
📝 Revision Notes: https://www.passthemsra.com/topic/syncope-revision-notes/
🧠 Flashcards: https://www.passthemsra.com/topic/syncope-flashcards/
💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/syncope-accordion-qa-notes/
🚀 Rapid Quiz: https://www.passthemsra.com/topic/syncope-rapid-quiz/
🎓 Full Course: https://www.passthemsra.com/courses/neurology-for-the-msra/

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