Team what's happening Zach here back for another podcast of med geeks so lately I've been seeing a ton of patients come through the ER with a chief complaint of syncopie

today I wanted to discuss an approach to the syncable patient, aka what are the red flag emergencies you just don't want to miss?

What are the common causes? What diagnostics are we ordering to help roll out bad things and figure out what's going on.

So let us begin.

So you have a 75 year old female with the past medical history of hypertension,

hyperlipidemia, aortic stenosis, and diabetes comes with a chief

complaint of passing out suddenly when she was walking to the bathroom.

She fell to the ground and luckily her son was there and caught her before she fell and did more damage.

This was followed by spontaneous recovery to her mental status baseline, so neurologic recovery.

Her son noticed that she was in her normal state of health

prior too. She had been eating and drinking okay, no shortness of breath, no

chest pain, no nausea, vomiting, diarrhea, no bloody stools or dark stools, no new medications.

So how are we going to approach this patient?

So first off, what is syncopi?

It's a quick abrupt short total loss of consciousness due to the brain just not being

perfused. And this is not being perfused not only just by blood, but it could be oxygen,

other nutrients like sugar so

never hypoglycemia for instance so typically it occurs when a patient is

standing or sitting position as the body's natural instinct is to drop to the ground

so that it's not fighting against gravity to get perfusion to the brain.

So this is why it normally happens when you're standing or sitting.

This loss of postural tone component comes as well. Following the event, you get this total

...