Mnemonic for syncope

 

 

Causes of syncope = HEAD, HEART, VESSELS

 

H = Hypoglycemia / Hyperglycemia (DKA) / Hypoxia

E = Epilepsy

A = Anxiety

D = Dysfunction of the brain stem

 

H = Heart attack / Right Heart failure

E = Embolism of pulmonary artery

A = Aortic obstruction

R = Rhythm disturbance (arrhythmia)

T = Tachycardia (especially ventricular tachycardia)

 

V = Vasovagal attack (i.e.: due to intense pain)

E = Ectopic heart beat (e.g.: complex ventricular ectopic activity)

S = Situational (micturition, defaecation)

S = Subclavian steal syndrome (proximal stenosis of subclavian artery)

E = Ectopic pregnancy (due to hemorrhagic shock)

L = Low vascular resistance

S = Sensitive carotid sinus / carotid sinus syncope (loss of consciousness can be rapid)

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New York Heart Association (NYHA) Classification

 

NYHA is a functional classification that describes the extent of heart failure. It consists of 4 categories based on patients limitation due to physical activity. This limitations or symptoms based on various degree of dyspnoea (shortness of breath) and/or angina.  

NYHA class Description
I               Heart disease is present, but no undue dyspnoea from ordinary physical activity (e.g.:  walking and climbing stairs)
II Comfortable at rest; have dyspnoea (shortness of breath) and/or angina on ordinary physical activity
III Less than ordinary activity (e.g.: walking in short distance within 20-100m) causes dyspnoea; marked limitation in activity due to symptoms
IV Dyspnoea present at rest; all activity causes discomfort. This is considered severe limitation. Patients are basically bedbound.

 Related topic:

Reference:

  1. Oxford Handbook of Clinical Medicine. 7th edition. 2008.
  2. http://en.wikipedia.org/wiki/New_York_Heart_Association_Functional_Classification
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