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A 76-year-old man comes to the office because of a brief loss of consciousness 2 hours ago. He was having dinner with two friends when he looked "pale" and slumped in his chair. He regained consciousness after about two minutes. He has a history of hypertension and coronary artery disease, which has been treated with two stents. His temperature is 36.8°C (98°F), pulse is 145/min, respirations are 18/min, and blood pressure is 90/68 mm Hg. Cardiac auscultation shows no murmurs. An ECG is obtained and the rhythm strip is shown below. Which of the following is the most likely diagnosis?
Presyncope can lead to syncope, so you can think of it as a spectrum of the disease.
The immediate treatment of an individuals with syncope or presyncope starts with laying the individual supine, with legs elevated if possible to help venous return to the heart and restore adequate brain perfusion.
Finally, you should attempt to arouse the individual without trying to raise them up until they’re ready.
Ok so once the individual has regained consciousness, the next step is to identify the cause.
This discharge may in turn be triggered by urination, defecation, coughing, prolonged standing, or a stressful event like seeing blood and needles.
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