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2024-11-12 04:02
Repeatedly fainting and being sent to the hospitalAfter repeated fainting and being sent to the hospital, the doctor might perform an examination and diagnosis from the following aspects:
** 1. Medical History Inquiry **
1. ** Fainting episodes **
- Ask about the cause of each fainting episode, such as whether it is after a specific activity (such as standing for a long time, strenuous exercise, sudden change of position, etc.), whether it is related to diet (such as hunger) or emotional state (such as nervousness and agitation).
- To understand the frequency, duration, and specific symptoms of fainting, such as whether there are premonitions (dizziness, dizziness, nausea, cold sweat, etc.), the degree of loss of consciousness, and the recovery.
2. ** Past Medical History **
- Understand whether there is a history of cardiovascular diseases, such as heart disease (cardiac arrest, heart attack, etc.), high blood pressure, stroke, etc. Cardiogenic syncope was more common in elderly patients. Heart diseases such as Sick Sinus Syndrome and high-grade Atriovenous Block could cause hemodynamics changes and lead to syncope.
- Ask if there is a history of nervous system diseases, such as epilepsy, epilepsy, etc. During a grand mal seizure, fainting and loss of consciousness may occur.
- Understand if there are any Metabolic diseases, such as low blood sugar, and so on. Low blood sugar syncope is more common in clinical practice. After low blood sugar is caused by a variety of reasons, there will be fainting phenomenon. Anemia may also lead to insufficient blood supply to the brain and cause syncope.
- Ask if you have a history of any diseases that may affect your body, such as hormonal diseases.
3. ** Family Medical History **
- Find out if there are relatives in the family who have similar fainting episodes. Some hereditary diseases may be related to fainting.
** 2. Physical Examination **
1. ** Vital signs check **
- Take your blood pressure and check if there is any low blood pressure or abnormal blood pressure fluctuations. For example, orthostatic low blood pressure may cause fainting.
- Check the heart rate and heart rhythm, and check if there is any cardiac syncope caused by cardiac anomalies (bradycardiac, cardiac, premature beats, etc.).
- Body temperature was measured. Fever may be related to infectious diseases (such as epilepsy), which may lead to fainting.
2. ** Nervous system examination **
- Check the state of consciousness, pupil response, limb muscle strength and sensation, and assess whether there is syncope caused by nervous system diseases. For example, cerebral syncope may be accompanied by positive signs of the nervous system.
** 3. Assist Examination **
1. ** Laboratory Examination **
- A blood test was performed to check if there was any signs of anesthesia. A low level of hemogloblin might indicate the possibility of anemia-induced fainting.
- Blood sugar levels were tested to determine if there was fainting due to low blood sugar.
- Electrolytes (such as potassium, calcium, etc.) should be checked. Electrolyte imbalance may affect the function of the heart and nervous system, which may lead to fainting.
- For patients suspected of infection, blood culture, C-reaction protein, white blood cell count, and other tests were performed to determine whether there was an infectious disease (such as epilepsy).
2. ** Electrocardiography (Ecg) Examination **
- Checking the electrical activity of the heart can help detect cardiac rhythms (such as sick sinuus syndrome, atrio-venous block, and cardiac tremor), which are common causes of cardiac syncope.
3. ** Cardiac-related examinations (if necessary)**
- An echo hologram was used to examine the structure and function of the heart to see if there were any problems such as dilated heart disease or valve disease that could cause cardiac syncope.
- Holter could record an electrocardiography for 24 hours or longer and was used to detect short episodes of cardiac arrest.
- For patients who are suspected of having cardiovascular disease, they may need to undergo examinations such as coronography to determine if there are any stenoses in the coronaries.
4. ** Brain related examinations (if necessary)**
- A CT or MRI scan of the head was used to investigate the cause of cerebral syncope, such as insufficient blood supply to the cerebral vessels, cerebral hemorrhage, cerebral hemorrhage, and other brain diseases.
- An electrography (EEG) examination is useful in the diagnosis of patients who are suspected of fainting due to epilepsy or other abnormal electrical activity of the nervous system.
** 4. Special examination (for specific diseases)**
1. ** For patients suspected of Vasovagal Syncope or Autone-Mediated Syncope **
- Tilting table test can be performed to assess the function of the autonomous nervous system and observe the changes in blood pressure and heart rate when the body position is changed.
2. ** For patients suspected of adenosine-sensitive syncope **
- Adenosine-sensitive syncope patients underwent detailed clinical and various examinations. The common causes of syncope were all negative, but they had a positive reaction to the adenosine-sensitive syncope test or the ATP-sensitive syncope test. The occurrence rate of this kind of syncope was about 1/4 of vasovagal syncope, accounting for 3% of the total number of patients with syncope, and 28% - 41% of syncope with unknown causes. It was more common in middle-aged and elderly women. The cause of this kind of syncope tended to be that the patient was hypersensitive to the effect of adrenaline. The increase of the body's intrinsic Ang or adrenaline could cause intermittent atrio-venous block or sino-auricle block, leading to prolonged cardiac arrest and syncope.
After determining the cause, the doctor would perform corresponding treatment according to the specific cause, such as cardiology treatment for cardiogenic syncope (medication to treat cardiac rhythm, improve cardiac function, etc.), neurology treatment for brain-derived syncope (treatment of stroke disease, control of epilepsy, etc.), or treatment for other causes (such as low blood sugar to supplement glucose, or to correct the severity of the disease). If it was adenosine-sensitive syncope, the main treatment included drug therapy and pacemakers because such patients were at risk of cardiac arrest and sudden death.
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