Question

A 71-year-old woman with hypertension, diabetes, and ischemic cardiomyopathy visits your office after a witnessed episode of syncope at a church gathering. She does not remember the event, but her daughter describes her suddenly appearing pale while sitting and then slumping over and hitting her head on the side of a table. After about 30 seconds she came to on her own. She has a normal physical examination except for an abrasion on her forehead and her only ECG abnormalities are the changes from her previous myocardial infarction. What type of syncope is most likely in your differential diagnosis?

1) Neurologic
2) Neurally mediated
3) Cardiac
4) Orthostatic
5) Psychiatric

Answer 1

The most likely type of syncope in the patient's differential diagnosis is cardiac syncope, which occurs when there is a sudden drop in blood flow to the brain due to a cardiac event.

Step-by-step explanation:

The most likely type of syncope in the patient's differential diagnosis is cardiac syncope. Given her medical history of hypertension, diabetes, and ischemic cardiomyopathy, it is possible that her syncope episode was caused by an underlying cardiac issue. The ECG abnormalities from her previous myocardial infarction further support this possibility.

Cardiac syncope occurs when there is a sudden drop in blood flow to the brain due to a cardiac event. In this case, the syncope episode may have been caused by a temporary decrease in cardiac output, leading to a brief loss of consciousness. It is important to further investigate and address the underlying cardiac condition to prevent future episodes.