暈厥syncope.pptVIP

晕 厥syncope 原南京中大附属医院神内科主任、硕士生导师 佛山大学医学院医学系孟红旗教授、主任医师 Professor、Doctor director 、Neurologist Definition of syncope Syncope is a symptom, defined as a transient, self-limited loss of consciousness, usually leading to falling. The onset of syncope is relatively rapid, and the subsequent recovery is spontaneous, complete, and usually prompt. The underlying mechanism is a transient global cerebral hypoperfusion. In some forms of syncope there may be a premonitory warning of an impending syncopal event, in another loss of consciousness occurs without warning. Recovery from syncope is usually accompanied by almost immediate restoration of appropriate behaviour and orientation. Retrograde amnesia, although believed to be uncommon, may be more frequent than previously thought, particularly in older individuals. Sometimes the post-recovery period may be marked by fatigue. Typical syncopal episodes are brief and usually they last nolonger than 20 s. Rarely, syncope duration may be longer even lasting for several minutes. In such cases,the differential diagnosis between syncope and other causes of loss of consciousness can be difficult. Presyncope or ‘near-syncope’ refers to a condition in which patients feel as though syncope is imminent. 晕厥的概念 概念：全脑血流量突然减少——短暂发作性意识丧失。 原因： 血压急骤下降 心输出量突然减少 脑动脉急性广泛的供血不足 1、Neurally-mediated reflex syncopal Syndromes 2、Orthostatic 3、Cardiac arrhythmias as primary cause 4、 Structural cardiac or cardiopulmonary disease 5、Cerebrovascular 1、Disorders resembling syncope with impairment or loss of consciousness, e.g. seizure disorders, etc 2、 Disorders resembling syncope without loss of consciousness,e.g. psychogenic syncope (somatization disorders), etc Real or apparent transient loss of consciousness Syncope: Non-syncopal: ↙ ↘ ↓ ↓ 2001 The European Society of Cardiology.Europace (2001) 3, 253–260 真实的或表面上的短暂意识丧失 晕厥： ●神经调节性 ●直立性低血压 ●作为首位原因的心律失常 ●器质性心脏或心肺疾病 ●脑血管性 非晕厥： ●没有意识损害的类似晕厥的紊乱，如跌倒，癔病等 ●有部分或完全的意识丧失的疾病，如癫痫病等 ↙ ↘ Ca