The Clinical Problem Solvers Episode 12 – Syncope with Dr. Stephanie Sherman
Jan 31, 2019
Dr. Stephanie Sherman, a clinician-educator at Baylor College of Medicine and an expert in internal medicine, dives deep into the intricate world of syncope. She discusses her comprehensive approach to evaluating patients with fainting episodes, emphasizing clinical reasoning and the importance of thorough bedside rounding. The conversation also touches on her experiences with resident training and her role in the Human Diagnosis Project. With a touch of humor, Stephanie reveals her love for re-watching The Office, blending serious medical insights with lighthearted anecdotes.
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Defining Syncope Precisely
- Syncope is a transient loss of consciousness due to global brain hypoperfusion with spontaneous recovery.
- The brain normally auto-regulates blood flow unless systolic blood pressure drops below about 50 mmHg.
Use Detailed Syncope History
- Ask patients to narrate the story moment by moment leading to syncope.
- Focus on their feelings in the days, hours, minutes, and seconds before loss of consciousness for diagnostic clues.
High-Risk Features of Cardiac Syncope
- A middle-aged man with cardiomyopathy and unheralded syncope is high risk for cardiac syncope.
- Lack of a prodrome and structural heart disease raises suspicion for a cardiac cause.
