Pre PACES Podcast #8 Collapses
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May 9, 2021 Dr. Ashley Nisbet, a consultant cardiologist and electrophysiologist at the Bristol Heart Institute, dives into the complex world of syncope and collapses. She emphasizes the significance of thorough history-taking and discusses the prevalence of syncope in exams. Listeners learn how to differentiate between seizure and syncope, recognize red flags, and the importance of witness accounts during episodes. The conversation also touches on management strategies for patients and wraps up with a fun quiz on 80s music!
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History Is The Diagnostic Cornerstone
- Syncope diagnosis relies primarily on a detailed history covering before, during, and after the event.
- Dr Ashley Nisbet stresses history gives most diagnostic clues rather than initial tests.
Ask About Triggers And Prodrome
- Ask about activity immediately before the event and specific prodromal symptoms like dizziness, sweating, or tunnel vision.
- Use those answers to distinguish vasovagal (with prodrome) from cardiac syncope (often no prodrome).
Witness Accounts Can Mislead
- Witness descriptions matter because lay observers often mislabel vasovagal jerks as seizures.
- Dr Ashley Nisbet explains syncope jerks are low-frequency, non-rhythmic, and occur with a floppy collapse.