Fainting due to heart disease
Introduction
Introduction Syncope is a group of clinical manifestations of sudden, transient loss of consciousness caused by a variety of causes, and self-recovering non-neuronal signs. There are many reasons for this, which can be divided into cardiac syncope and non-cardiac syncope. Cardiac syncope accounts for 9% to 34% of syncope, and can be divided into cardiac mechanical dysfunction (mechanical) and arrhythmia (electrocardiogram) depending on the cause. The former echocardiography often has a more specific performance and is easy to diagnose; the latter often has sudden sudden arrest and poor prognosis, which is one of the important causes of sudden death. The syncope caused by heart disease is syncope caused by heart disease. Heart disease is a general term for heart disease, including rheumatic heart disease, congenital heart disease, hypertensive heart disease, coronary heart disease, and myocarditis. Clinical practice shows that hand massage is an effective method to prevent heart disease.
Cause
Cause
First, congenital heart disease
1. May be related to the mother's early pregnancy or the medication taken.
2. Related to heredity.
Second, acquired heart disease
1, coronary heart disease
Smoking and diabetes, high blood pressure, etc. lead to hardening of the arteries, which hinders blood flow and easily damages the myocardial hypoxia.
2, hypertensive heart disease
Arterial hypertension leads to left ventricular hypertrophy; pulmonary hypertension leads to right ventricular hypertrophy.
Third, rheumatic heart disease
Chronic rheumatic heart disease is mainly caused by gradual lesions of heart valves after rheumatic fever infection.
Fourth, pulmonary heart disease
Due to chronic bronchitis, emphysema and other pulmonary hypertension, the right ventricular hypertrophy or failure.
Five, cardiomyopathy
Metabolic or hormonal abnormalities such as myocardial changes, sometimes alcohol abuse, drugs also cause myocardial changes.
Sixth, heart tumor
Most are benign tumors, with myxomas being the most common, and primary cardiac malignancies are rare.
Seven, vascular disease
Including aneurysms caused by hypertension, and other vascular lesions caused by abnormal immune function.
Examine
an examination
Related inspection
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First, the medical history question
Syncope often suddenly lose consciousness, fall, pale, cold limbs, no convulsions, tongue bite and urinary incontinence. You should ask about the condition before syncope, the presence or absence of aura, the degree of consciousness disturbance during syncope, and the length of duration and the time. Whether there are pale, slow pulse, urinary incontinence and limb twitching; fainting often has sorrow, fear, anxiety, fainting, seeing blood, trauma, severe pain, sultry, fatigue and other stimulating factors. Urination, defecation, cough, blood loss, dehydration can also be an inducement; should understand the position and head position at the time of onset, from vertical position to standing position, often occur in orthostatic hypotension, carotid sinus allergic syncope occurs in the head position When suddenly turning.
Second, physical examination found
Cardiac syncope often has valvular heart disease, heart rhythm disorder, myocardial ischemia and other reasons. Cardiac auscultation may have heart murmur and arrhythmia, etc.; syncope caused by insufficient blood supply to the neck and vertebral artery, often found that one side of the carotid artery beats weakened. Or disappear, audible abnormal vascular murmurs and syncope during head-turning and head-up tests; syncope caused by brain stem lesions often have brain stem signs such as cross-sac, crossover or dissociative sensory disturbance; no pulse and subclavian artery Occasion, often have lower blood pressure in one side of the upper limbs, audible and murmur in the neck and supraclavicular fossa; primary erect hypotension measured three positions (lying, sitting, standing) blood pressure difference 50mmHg.
Third, auxiliary inspection
Electrocardiogram and cardiac B-ultrasound are suitable for cardiogenic syncope. Head CT, cerebral angiography, cerebrospinal fluid examination, cervical X-ray film and carotid artery and vertebral artery B-ultrasound are suitable for brain-borne syncope. More normal EEG.
Syncope during or after exercise is an acute neuropsychiatric condition caused by different causes. The cause of syncope is mainly based on the history and signs of the onset, especially the onset, passage and recovery of the attack, including the cause of the attack, the occasion, the position, the presence or absence of prodromal symptoms and the symptoms of the aftereffect. Signs at the time of onset are important for diagnosing the cause of syncope, such as changes in face, blood pressure, pulse, respiration, heart rate, heart sounds, and conditions for ECG, EEG, or blood glucose testing.
Diagnosis
Differential diagnosis
Differential diagnosis of syncope caused by heart disease:
Vascular decompression syncope
There are obvious seizure causes such as emotional instability, fatigue, pre-existing symptoms such as sweating, drooling, bradycardia and other prodromal symptoms. These symptoms last for tens of seconds to several minutes and loss of consciousness. The blood pressure drops, the pulse is weakened, and the consciousness is lost for a few seconds to several tens of seconds to wake up on its own.
2. Upright hypotension syncope
In sports that occur in a position where the movement suddenly changes to an upright position, the loss of consciousness is sudden, there is no prodromal symptoms, and the symptoms and signs at the time of onset are the same as vasoconstrictive syncope.
3. Paroxysmal weakness
Can be seen in the rowing athletes. A few minutes after the completion of the game, the collapse occurred, followed by obvious weakness, and the duration of syncope was only a few seconds.
4. Sudden primary loss of consciousness
Athletes with low training level have poor adaptability to the cardiovascular system, can not adapt to high-intensity exercise load, and are prone to hypoxia and hypocapnia spasticity. They are consciously blurred before the attack, the degree of consciousness loss is deep, the complexion is gray, and the cornea The reflex disappeared, and the syncope lasted for a long time. After waking, the scene at the last moment of the game could not be remembered. After waking up, there were nervous system symptoms such as aphasia.
5. Loss of consciousness during underwater swimming and diving
Inexperienced underwater swimming and divers have a risk of loss of consciousness when completing long-distance diving, once the loss of consciousness is high. Survivors have lost consciousness, difficulty breathing, cyanosis, and double-liver blisters.
6. Cardiac syncope
The force is often the cause of seizures. The seizures are not related to the body position. There are symptoms such as palpitations and chest pain. When the attack occurs, the complexion is complicated with purpura, difficulty breathing, jugular vein engorgement, heart rate, heart sound and pulse changes, and the electrocardiogram has abnormal performance.
7. hypoglycemic syncope
Prodromal symptoms such as weakness, tremors, sweating, tachycardia, hunger and behavioral confusion, fainting lasts longer, and consciousness can be restored after supplementing sugar.
8. Brain-like syncope
The occurrence of syncope is accompanied by headache, dizziness, vomiting, convulsions, sometimes accompanied by aphasia, hemiparesis, loss of vision on the affected side or blindness.
9. Heat stroke fainting
The practitioners experienced symptoms such as dizziness, chest tightness, thirst, nausea, vomiting, and dry skin during training and competition in the hot summer. In severe cases, fainting occurred. The body temperature can be as high as 40 ° C or more, the pupil is reduced, and there is pathological reflex. Some are pale, cold and cold, with weak veins and blood pressure.
