2 Syncope due to orthostatic hypotension (OH): drug-induced OH, volume depletion or autonomic failure (neurogenic OH).1 Reflex (neurally mediated) syncope: includes vasovagal syncope, situational syncope and carotid sinus syndrome.It should be distinguished from nonsyncopal causes of TLOC that are not attributed to cerebral hypoperfusion, which include conditions such as seizures, traumatic brain injury (eg, concussion), accidental falls, drug or alcohol intoxication, metabolic disturbances (eg, hypoglycemia), sleep disorders such as narcolepsy and cataplexy, and conversion disorders including pseudoseizures and pseudosyncope.Ĭauses of syncope are generally grouped into three major categories: It is characterized by a rapid onset, short duration (rarely lasting more than a minute or two), and spontaneous complete recovery. Syncope is defined as a transient loss of consciousness (TLOC) caused by cerebral hypoperfusion and is associated with an inability to maintain postural tone. Syncope articles Carotid Stenosis articles Carotid Hypersensitivity articles Carotid Endarterectomy articles Article Details 1. Syncope Carotid Stenosis Carotid Hypersensitivity Carotid Endarterectomy The literature revealed older studies of syncope resolution following carotid endarterectomy in patients with specific characteristics their detailed features are identified here, and revealed that evaluation of carotid sinus syndrome did not require carotid ultrasound.Ĭonclusions: Carotid revascularization is not recommended for unilateral asymptomatic carotid artery stenosis to treat isolated syncope, and carotid ultrasound is not needed in the evaluation of carotid sinus syndrome and rates of neurological complications following carotid sinus massage were low. Results: 34% of medical providers surveyed considered carotid endarterectomy for isolated syncope treatment for unilateral high-grade carotid stenosis and 45% of surveyed providers considered carotid ultrasound in evaluating carotid sinus syndrome. Literature was reviewed for carotid ultrasound use in syncope. We searched the literature to identify cases in which carotid revascularization improved syncope, and whether or not carotid ultrasound was used to evaluate carotid sinus syndrome. Methods: We conducted a clinical survey of 206 internal medicine providers, to explore how many would consider unilateral carotid revascularization to treat isolated syncope, and how many would consider carotid ultrasound in evaluating carotid sinus syndrome. Unclear concepts in syncope workup and management are identified. Objectives: This article reviews the impact of asymptomatic carotid artery stenosis on management of syncope, and the role of carotid Doppler ultrasound in carotid sinus syndrome and in syncope. View / Download Pdf Share at Facebook Abstractīackground: In clinical practice, some investigations can have low diagnostic yield or little impact on treatment. Cardiology and Cardiovascular Medicine 5 (2021): 106-122. Carotid Artery Stenosis in Syncope and in Carotid Sinus Syndrome: A Few Concepts for the General Practitioner to Know. Received: 07 January 2021 Accepted: 20 January 2021 Published: 25 January 2021Ĭitation: Emran El-Alali, Shadi Abu-Halimah, Laith Maali, Yaman Alali. *Corresponding author: Emran El-Alali, Department of Medicine, Anne Arundel Medical Center, 2001 Medical Pkwy, Annapolis, MD 21401, United States Carotid Artery Stenosis in Syncope and in Carotid Sinus Syndrome: A Few Concepts for the General Practitioner to Know Article InformationĮmran El-Alali 1*, Shadi Abu-Halimah 2, Laith Maali 3, Yaman Alali 4ġDepartment of Internal Medicine, Anne Arundel Medical Center, Maryland, United StatesĢAssociate Professor, Department of Surgery, Vascular and Endovascular Surgery Division, West Virginia University, WV, United StatesģAssistant Professor, Department of Neurology, University of Kansas Medical Center, Kansas City, United StatesĤInternal Medicine Resident, Department of Internal Medicine, Creighton University, Omaha, United States
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