syncope

• related: Cardiology, pacemaker, bradycardia

• syncope: short ddx
• presyncope: very long ddx
• good history is very important
  • differentiate between true syncope vs presyncope
  • does this sound like arrhythmia, tachy brady syndrome
  • cereral hypoperfusion
    • abrupt, no prodromal, no confusion
    • lights off/on
    • no tired/confused/postictal
  • PE: carotid sound
  • ECG

This patient has most likely experienced cardiogenic syncope due to ventricular tachycardia (VT); scarring from previous myocardial infarction (evidenced by Q waves on ECG) increases the risk of ventricular arrhythmia. Syncope due to VT usually has no warning symptoms (other than palpitations in some patients). The arrhythmia spontaneously terminates within a few minutes, resulting in restoration of cardiac output and rapid patient recovery with no residual symptoms.