The differential diagnosis of syncope and presyncope.pdf

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The differential diagnosis of syncope and presyncope
Lightheaded
Yes

No

Presyncope (reduce
cerebral perfusion)

Yes

Cardiac causes:
1. Arrhythmia
2. Left ventricular
dysfunction
3. Aortic stenosis
4. Hypertrophic obstructive
cardiomyopathy
Non-cardiac causes
1. Vasovagal syncope
2. Postural hypotension
3. Micturition syncope
4. Cough syncope
5. Carotid sinus sensitivity

Sensation of movement
(vertigo)

No

Yes

1. Anxiety
2. Hyperventilation
3. Post-concussive
syndrome
4. Panic attack
5. Non-epileptic attack
6. Hypoglycemia

1. Central vestibular dysfunction
2. Labyrinthine dysfunction

No

Loss of balance
1. Ataxia
2. Weakness
3. Loss of joint position
sense
4. Gait dyspraxia
5. Joint disease
6. Visual disturbance
7. Fear of falling

Note:
1. Anxiety is the most common cause of dizziness in those under 65 years
2. Other description of the patient my indicate epileptic seizure

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