Orthostatic Syncope (Archived)

Excerpt

Syncope is a common presenting complaint. It refers to a transient or passing loss of consciousness resulting from a reduction in cerebral blood flow and is usually associated with a loss in postural tone but with spontaneous recovery. Syncope can occur without symptoms or can be preceded by symptoms like dizziness, diaphoresis, nausea or blurred vision. It can be a recurrent or a single event. Unexplained recurrent syncope in patients with structural heart disease has a statistical association with 40 percent mortality in 2 years.

Classic orthostatic hypotension occurs when there is a persistent reduction in blood pressure of at least 20mmHg systolic or 10mmHg diastolic within 3 minutes of standing or being upright to 60 degrees on the head-up tilt table. In patients with initial orthostatic hypotension, the decrease in blood pressure occurs within 15 seconds, while in those with delayed orthostatic hypotension it occurs after over 3 minutes of assuming an upright position. Orthostatic syncope refers to syncope resulting from a postural decrease in blood pressure.