Title: Life-Threatening Causes of Syncope
题目：造成晕厥的危机生命的原因
Author 作者: Semhar Tewelde

• Syncope is a sudden lack of blood supply to the brain typically caused by a problem in the regulation of blood pressure or a problem with the heart
• 晕厥是大脑突然没有血液供应所致，通常由血压调节紊乱或心脏问题引起
• Syncope can be broadly classified in 3 categories neural reflex (~60%), orthostatic (~15%), and cardiac (~15%)
• 晕厥大致可分为3类；神经反射（〜60％），体位性（〜15％），和心脏因素（〜15％）
• Even in the absence of a firm diagnosis of cardiac syncope, the presence of known structural heart disease (CAD) or evidence a primary electrical disorder is associated with a poor prognosis
• 即使在没有明确心源性晕厥诊断情况下，已知的结构性心脏疾病（CAD）或有电传导紊乱的证据都与不良预后相关
• Cardiac causes of syncope can also be divided into 3 categories: structural heart disease, obstructive lesions, and arrhythmogenic potential
• 心脏晕厥的原因也可分为3类：器质性心脏疾病，阻塞性病变，和潜在的心律失常
◦ Structural: Ischemic heart disease, dilated cardiomyopathy, etc
◦ 结构性：缺血性心脏疾病，扩张型心肌病等
◦ Obstructive: HCM, aortic/mitral stenosis, atrial myxoma, pulmonary HTN, PE, tamponade
◦ 阻塞性：肥厚性心肌病，主动脉瓣/二尖瓣狭窄，心房粘液瘤，肺高血压，PE，心包填塞
◦ Arrhythmogenic:
◦ 心律失常因素：
▪ Brady: AV block, sick sinus, sinus arrest/pause
▪ 过缓：病态窦房结，房室传导阻滞，窦性停搏/暂停
▪ Tachy: SVT (AVNRT/AVRT), accessory pathways (WPW), or primary arrhythmias
▪ 过速：SVT（AVNRT/ AVRT），旁路（WPW），或原发性心律失常

References
Khoo C, Chakrabarti S, et al. Recognizing Life-Threatening Causes of Syncope. Cardiology Clinics. Volume 31, Feb, 2013