671
edits
Initial evaluation: Difference between revisions
Jump to navigation
Jump to search
no edit summary
Jelledejong (talk | contribs) |
Jelledejong (talk | contribs) No edit summary |
||
| (13 intermediate revisions by the same user not shown) | |||
| Line 1: | Line 1: | ||
<span style="font-size:130%>This page is also available in Dutch: [[eerste evaluatie]]</span> | |||
==Flowchart for the initial evaluation of syncope== | ==Flowchart for the initial evaluation of syncope== | ||
[[File: | [[File:Seh_flowchart_tloc.jpg|1000px]] | ||
==Goal== | ==Goal== | ||
| Line 52: | Line 52: | ||
====During the end of T-LOC==== | ====During the end of T-LOC==== | ||
*Pallor, sweating, nausea, abdominal discomfort, vomiting | *Pallor, sweating, nausea, abdominal discomfort, vomiting | ||
*Incontinence of urine <span style="color:#008000> | *Incontinence of urine or <span style="color:#008000>defecation</span> | ||
*<span style="color:#008000>Prolonged confusion</span> (i.e. dysfunctional imprinting; sleeping is not confusion) | *<span style="color:#008000>Prolonged confusion</span> (i.e. dysfunctional imprinting; sleeping is not confusion) | ||
*<span style="color:#008000>Myalgia</span> | *<span style="color:#008000>Myalgia</span> | ||
| Line 61: | Line 61: | ||
*<span style="color:#FF0000>Familial acute death < 40 years old with an unknown cause</span> | *<span style="color:#FF0000>Familial acute death < 40 years old with an unknown cause</span> | ||
*Many episodes of T-LOC/long duration of T-LOC (psychogenic) | *Many episodes of T-LOC/long duration of T-LOC (psychogenic) | ||
*Medication (anti diabetic drugs, | *Medication (anti-diabetic drugs, anti-hypertensive drugs, psychiatric medication), intoxications | ||
====Useful information from anamnesis==== | ====Useful information from anamnesis==== | ||
| Line 69: | Line 69: | ||
===Points of interest=== | ===Points of interest=== | ||
*Auscultation of the heart: are indications for structural heart disease present or an arrhythmia present? | *Auscultation of the heart: are indications for structural heart disease present or an arrhythmia present? | ||
*Supine and standing blood pressure and pulse | *Supine and standing blood pressure and pulse: After 5 minutes of supine rest the blood pressure and pulse must be measured at least twice. The patient then rises from supine to standing position. Within 3 minutes of standing the blood pressure and pulse must be measured again. One speaks of orthostatic hypotension if the systolic blood pressure drops with at least 20 mmHg, or the diastolic blood pressure drops with at least 10 mmHg within 3 minutes. If the blood pressure dropped it is wise to continue measuring while standing to see if it will drop further. One must also ask the patient if he/she experiences symptoms during standing. | ||
*Neurological examination: in particular attention for the lateral tongue bite | *Neurological examination: in particular attention for the <span style="color:#008000>lateral tongue bite </span> | ||
*Trauma (capitis) due to a fall during T-LOC | *Trauma (capitis) due to a fall during T-LOC | ||