Forgot to mention! After monitoring the patient for 24 hours, often they can be discharged if the workup is negative - however, one common device we may order is called a Ziopatch. It’s basically like a portable cardiac monitor that can be worn for 1-2 weeks to catch any possible arrhythmias that didn’t happen while they were in the hospital (as opposed to Holter monitors which usually are just worn for 24-48 hours). A nice benefit too is that they can be worn while showering!
Great lecture! However would add that syncope is a subtype of TLOC and is due to transient global impairment of cerebral perfusion; whereas neurological causes of TLOC would include seizure or in the presence of focal neuro deficits might include vertebrobasilar insufficiency and subclavian steal syndrome. However, worth mentioning there is no intrinsic neurological cause of syncope, which is a cardiovascular phenomenon
Great 10 min video! One of my med school professors used to have a framework for syncope very similar to AKI (pre renal, renal, post renal).. he used to classify syncope as pre cardiac, cardiac and post cardiac .. turns out the etiologies you listed under the classification you used can easily be used under the pre cardiac - cardiac - post cardiac ! Just thought you’d be interested in knowing this 😊
Thanks Dr. Shubha! I love that framework, it seems so simple and easy to remember :) Do you remember if they would classify both vasovagal syncope and orthostatic syncope as precardiac? Or would one of them be postcardiac
Great video. I was wondering if you could do a video on running a code blue. Also, any resources you recommend for running a code blue as a team leader. Just entered PGY2 and we are expected to run codes as team leaders as a senior resident. Thank you.
Hey Conan! Love your videos! Just curious would you happen to have a bible of an Anki deck for residency in internal medicine. I’m an intern and can sometimes be so lost with all of the protocols
Thanks Macbethman :) I don't have any specific Anki decks - I really would just recommend making your own cards (that's what I do) and making like a OneNote where you write down all the protocols and stuff that you learn, that way when you come back on a specific rotation later you have all the notes you wrote from before and can easily pick up from where you left off!
@@ConanLiuMD ty so much!! so we need three measurements then. Do you think it’s because some people can have “low BP episode” faster/slower than others? I mean we can diagnose it in two different scenarios like: Supine 120/80 Stnd 1 min 95/70 Stnd 3 min 105/75 Supine 120/80 Stnd 1 min 105/75 Stnd 3 min 95/70 If we measured “standing BP” only once we would have missed the diagnose.
Forgot to mention! After monitoring the patient for 24 hours, often they can be discharged if the workup is negative - however, one common device we may order is called a Ziopatch. It’s basically like a portable cardiac monitor that can be worn for 1-2 weeks to catch any possible arrhythmias that didn’t happen while they were in the hospital (as opposed to Holter monitors which usually are just worn for 24-48 hours). A nice benefit too is that they can be worn while showering!
A comprehensive quick review of syncope, thumbs up! An event monitor may be considered in true syncope of unclear etiology.
Yes forgot to mention that in the video!! Thanks ❤️
Just discovered your channel. Brilliant video, straight to the point. Liked and subcribed!
Thx for making this ! We do mini inservice for the nurses in the ICU I work at and this is a spectacular overview.
Again, love your lecture!
Great lecture! However would add that syncope is a subtype of TLOC and is due to transient global impairment of cerebral perfusion; whereas neurological causes of TLOC would include seizure or in the presence of focal neuro deficits might include vertebrobasilar insufficiency and subclavian steal syndrome. However, worth mentioning there is no intrinsic neurological cause of syncope, which is a cardiovascular phenomenon
Great 10 min video! One of my med school professors used to have a framework for syncope very similar to AKI (pre renal, renal, post renal).. he used to classify syncope as pre cardiac, cardiac and post cardiac .. turns out the etiologies you listed under the classification you used can easily be used under the pre cardiac - cardiac - post cardiac ! Just thought you’d be interested in knowing this 😊
Thanks Dr. Shubha! I love that framework, it seems so simple and easy to remember :) Do you remember if they would classify both vasovagal syncope and orthostatic syncope as precardiac? Or would one of them be postcardiac
Great video with a good approach! In addition to the above, I also think of pulmonary embolism as a cause of syncope :)
Great video. I was wondering if you could do a video on running a code blue. Also, any resources you recommend for running a code blue as a team leader. Just entered PGY2 and we are expected to run codes as team leaders as a senior resident. Thank you.
Will try to make one soon and thanks! :)
Hey Conan! Love your videos! Just curious would you happen to have a bible of an Anki deck for residency in internal medicine. I’m an intern and can sometimes be so lost with all of the protocols
Thanks Macbethman :) I don't have any specific Anki decks - I really would just recommend making your own cards (that's what I do) and making like a OneNote where you write down all the protocols and stuff that you learn, that way when you come back on a specific rotation later you have all the notes you wrote from before and can easily pick up from where you left off!
@@ConanLiuMD thank you so much! I could see this working! Wishing you the best in your last year of IM residency!
Does postprandial syncope come under reflex syncope and can it happen in a sitting position ? Would love to know your view on this please
I had a panic attack while standing in line and experienced vasovagal syncope
Ｐｒⓞм𝕠𝕤𝐌
I think standing should be 2-5 minutes for orthostatic not one minute?
Per the CDC: www.cdc.gov/steadi/pdf/STEADI-Assessment-MeasuringBP-508.pdf
@@ConanLiuMD ty so much!! so we need three measurements then. Do you think it’s because some people can have “low BP episode” faster/slower than others? I mean we can diagnose it in two different scenarios like:
Supine 120/80
Stnd 1 min 95/70
Stnd 3 min 105/75
Supine 120/80
Stnd 1 min 105/75
Stnd 3 min 95/70
If we measured “standing BP” only once we would have missed the diagnose.