Syncope: Benign vs. Deadly | EM & Acute Care Course

[@cozymountain]

I’ve been in the ER 10 plus times in my life for passing out - not until 2 years ago did anyone tell me about syncope. I’m so grateful to know that causes me to collapse and sweat and get sick out of nowhere. I’m only 42 - this has happened since I was a teenager.

[@calebchristopher9283]

Can it be corrected?

[@Thornlessrose39]

A great topic of discussion. I have Bradycardia along with migraine symptoms(Hemiplegic Stroke like ones) that lead to unconscious events,these starting back in May 2022. I was told I have essential tremor but have also been experiencing seizures of unknown causes. A cardiologist who I saw a few years ago told my Gp that I have PR 1st degree heart block with Syncope. I am under the care of many different Specialists. Back and forth trips by ambulance to ED and sometimes nothing is done under than observation with a 12 lead heart monitor,ecg and BP checks as I also have Hypotension problems. I am due to have my first EEG tomorrow. When I do become unconscious though I am often lying down and have had to have CPR done 4 times due to these recurring events. My first Syncope episode was back in 2020 during a vomiting attack reaction to a colon prep medication,so this has been going on for quite some time.My recent hospital trip was rather uneventful after a doctor told me that I looked normal to him and refused to help,I'm glad for my other Specialist team as they are doing all they can to help.

[@bernieboland6474]

A great talk! My friend had two fainting spells or syncope in a 3 week time, the last fall (with the faint) he had a laceration on back of his head 9 stables, he was blessed someone saw him fall and called 911, saved his life! He was on Tamsulosin HCL 0.4mg. we stopped the med and no more fainting or synope spells. Dizziness and fainting, side effect of Tamsulsin!

[@MedimanND]

So the alpha blockers are the issue in his case then?

[@jacklawer6389]

Thanks Happened to me too 10 staples in my head.? I don't know what to do, go to hospital and get checked out i guess

[@JamshedKhan-qk1bz]

That’s why Dr often prescribed Tamsulosin 0.4 mg at Night !!! Bcz it’s common effect is Hypotension (low BP) Always discuss issues with doc! TC all ❤

[@rikiensons]

Would love to have this dr look at my chart..

[@shirahime23]

When I passed out at a hospital a few years ago (was accompanying an older friend get an MRI), the medical staff checked my blood sugar (normal), followed by an EKG (also normal, but there was a note by the technician). I'm glad that the doctor whose care I was under did the second test, in keeping with what Dr. Hoffman says here.

[@MuhammadAli-ml9bt]

DR Jerome Hoffman, MD I LOVE YOU

[@logancade342]

Thank you, medical George Carlin 💙

[@justbecause160]

I agree 🤣

[@justinapodaca4776]

one in the same.

[@MarkShinnick]

I wish George and he had been buds.

[@jacko3423]

It reminds me when George was talking about people carrying water bottles.

[@catherine5446]

Where are you Dr. Hoffman??? Need more lectures

[@2manycatsforadime]

Situational syncope. My pulse is normal all day. Eating and drinking will trigger lightheadedness to almost falling down. I do not passout.. Morning breakfast the worst. Late in the day eating and drinking will cause a lightneadedness but nothing like in the morning . Pulse goes up during these episodes, never down and normal pulse is around 73. Can't find a DR who knows jack about this, I am doing all the discoveries.

[@amiraabidin8092]

I noticed I had this too after mealtime esp. When it big. Felt like palpitation but it was actually low pulse. Occasionally I get it too when stressed out. I might need to get check for any heart blockage.

[@ayatullahhassan392]

I cant thank you enough for such helpful and fantastic lecture by dr hoffman .. i wish you upload more videos with neurology related content .. again, thank you 👌

[@AutumnsVeiling]

Terrific, thanks for the thought provoking content

[@rosewhite---]

ACID REFLUX INDUCED SYNCOPE. If you have bad acid reflux for many weeks or months the lower gullet sphincter seems to stop working so food backs up in the gullet and feels like you cannot swallow or are choking. Then the pressure of the food causes pressure on the blood vessels from the hart and that reduces blood flow to the brain which suddenly shuts down. It is quite terrifying when it occured to me three times in ten days.

[@2manycatsforadime]

This sounds similar to situational Syncope/swallowing. Have you checked your blood pressure directly after and then fully recovered?

[@rosewhite---]

@@2manycatsforadime It wasn't situational syncope as each time it happened I was leisurely eating small meal at home. It happened during lockdown and I couldn't get to doctors but got a phone call to one who said he thought I might have throat cancer and arranged endoscopy but it showed everything lovely pink and clean. The reflux was due to 2 years extreme stress of lockdown and neighbours having tvs blaring from 6am to after midnight. Worst neighbour died so I got some peace and doctor prescribed Omeprazole that I took for a couple of weeks but now only take every few days when I have been eating baked goods. Couldn't get blood pressure tested during the syncope period due to lockdown. So many people take all the antacids advertised on tv instead of altering diet!

[@2manycatsforadime]

@@rosewhite--- Thanks for the reply Rose. I bought a blood pressure cuff from a local big box pharmacy so I could moniter what is going on.

[@rosewhite---]

@@2manycatsforadime I didn't think of that as all UK doctors now have selfservice monitors and my pressures are always fine.

[@richricogranada9647]

Terrifying to me too as I live alone and when it happens it could be on the house tile and hit my head, or while driving. I also have lots of burps and tachycardia.

[@thelookanchannel2560]

After i enter our hot tub, i almost always get syncope, i didn't realize it was an issue until i passed out today. I felt sick and foggy headed for half an hour after the few seconds i passed out for.

[@MuhammadAli-ml9bt]

DR HOFFMAN I LOVE YOU

[@sgtrock2821]

I'm 61 and workout hard still every day. My last 2 chest and back workouts I got syncope bad when I stand up after doing bent over rows and dumbell rows. Like I'm gonna pass out between sets. I can do bench, dumbell presses, flys, pecdeck, lat pulldowns, pull ups, upright rows, lateral raises, flys, and shrugs without syncope. It's only when I raise after doing bent over movements. Very frustrating. I'm gonna go to the VA ER tonight since I have to wait 3 months for a Primary Care Appointment.

[@JH-jo9wt]

Just happened to me tonight, not in the gym but was on the toilet bent over, when i stood up boom sycope grazed my knee pretty bad and my head just missed a sharp cabinet.

[@scrumptious9673]

Keep us updated!

[@Mikeppodcast]

Great video. So how do we treat arrhythmias?

[@richricogranada9647]

Could it be heart murmur symptom? I had my first black out this AM while brewing coffee and slumped over the stove. I have lots of burps and tachycardia. I’m afraid to drive and have another episode. How to avoid another episode?

[@BlueandBats]

Lay down, feet above head, wherever you are. Pass a ball back and forth between your hands.squeeze a ball or touch any funny fabric. Keep your focus. Breathe slow and deep. Focus on something. Clench legs in every muscle. Clench hands away from each other. Clench teeth. If you can't lay down sit down. Ideally lay down. Don't let anyone around you lift your head up above your body. (Strangers trying to help) writing a note if possible to keep om your personal can help as well. Try to get someone to get you water, and even something with salt. Sugar can help if you feel hungry. Sometimes can not (sugar) help. Focus on something good. Surrender but keep your focus on something. Calm the heart. Release any emotions about anything by crying or pther forms of release. If it's hard to focus, switch your focus around to more than one things, alternating. Be present. Be calm not afraid. Ask /call for help. Search for videos about it. Hope it helps

[@emaginate1]

Call 9-1-1 better safe than sorry. It's surreal for me. Omg😮

[@technofly77]

thanks dr hoffman, briliant as always

[@teresasardinas5642]

That was exactly what happened to me and the Drs. don’t know why. I felt bad all of the sudden and then I went down.

[@gabrn1]

Excellent! Cuts to the chase!

[@Mikeppodcast]

I have syncope with my heart racing and slowing but doctors say I'm fine. I have severe sweating, sensation to defecate and eventual pass out. But it seems to be stimulated by visual too. Constant eye pain. No epilepsy

[@taylorparker8912]

I have the same condition and I don’t know what’s to do, best of luck and healing.

[@Mikeppodcast]

@@taylorparker8912 Thank you! I hope you heal also. Don't eat processed foods and no sugar. Get fructose from fruits.

[@SanalMG]

I am not sure, syncope needs global lose of blood supply to the brain. A mere loss of blood to thalami is sufficient. Redinbaugh et al. show that, hthe central lateral thalamus has a key role in the control of consciousness, through the modulation of specific corticocortical pathways.

[@LawofMoses]

I don't remember waking up March 25th the day after I had a covid home test spritz me in the eyes(sodium azide). That morning from what I am being told I woke up got dressed and then for some reason had a bath which I don't do, after which I started throwing up profusely and went and laid on my bed to have a convulsion which they describe as a grand mal like seizure. An ambulance came and got me, took me to hospital. While there they said I had another seizure and became violent. They sent me to another hospita(1.5 hrs one way) by ambulance for a CT scan then returned to local hospital and then by about 10pm they called NY wife to come get me. I don't remember anything since the Nighy before. It's been 4 weeks and no more symptoms at all. While at the hospital I also somehow had my t5 and t12 vertebrae fractured. The Dr isn't sure but they are sending me for tests to see if I have epilepsy. I am 50, healthy, I eat right, I don't drink or smoke. I do suffer from extreme pain and depression already. I don't have any other pressure in life. My bills are paid and I own a home. I am wondering if a seizure can break a healthy person's bones and just come out of the blue. I did have one syncope incident several months previously but woke immediately after 30 to 50 seconds. Any interesting comments from professionals?

[@naturelove7727]

Same with my husband problem 😢 few episodes looks like epilpdy seizure but doctor confirmed that he has no epilepsy..it always triggers when he is standing/sitting on the line long or stress and lack of sleep.Im always scared as a wife.😢

[@neruraj527]

@@naturelove7727 I sympathise as the wife of someone who has had 4 episodes in eight years. All tests seem normal - was prescribed blood pressure medication after the first one and taken off four years later after 3rd episode.

[@jorgezepeda7288]

I have the perfect match. Vasovagal Syncope and Chronotropic incompetence!😢

[@louisvarre2197]

Simplistic approach. Common-sense approach!

[@engr.msjalal9092]

Doctor advised me to set up ICD, os it required, i have 7 times sycope in last 6 months, but last 1.5 months 4 times. What to say, can i set ICD or I will take medicine???

[@catherine5446]

This is so good.

[@AlisonGwynethBrown]

I get this and people say its only a faint well l become asystolic then come back after 14 seconds so far Cut my head falling in itu

[@richricogranada9647]

I can sleep on my left side as I have neck artery pain and had syncope

[@dhilondasgupta5005]

How to prevent? is there any medicine to cure syncope? Kindly intimate

[@angusmcmillan8981]

You didn’t mention heart block

[@GreySteel]

He mentioned arrhythmia, and that's what a heart block IS.

[@alifti4130]

Logical and crisp 👍

[@Marconel100]

I have presyncope all day since this morning and I have no idea why, blood pressure fine, sugar levels fine, salt fine, I have no idea what's going on.

[@theredshadow360]

Hey! I know I am a year later replying to this comment of yours. However, I identify very much with you! How are you currently?

[@Marconel100]

@@theredshadow360 I'm still fine, symptoms passed by themselves, just get some rest and if you have any chronic, check up on that aswell

[@theredshadow360]

Glad to hear you are doing better! And oh boy, I have been through presyncopal episodes for about 3 months already. No answers and a cardiologist gave up on me too

[@reneetringali2583]

Thank you.

[@antaya715]

Very interesting thank you 😊

[@saberalquhaif9145]

thank you

[@reemfandi2996]

What his name ? he have more video?

[@ccme_courses]

Hi name is Jerome Hoffman, if you look on KZbin you should be able to find more videos of him.

[@PatHaskell]

Ectopic pregnancy doesn’t cause hypovolemia, but a ruptured one can.

[@rasapabrinkiene3273]

An excellent lecture, criticism to NICE 😂. May I disagree? NICE guidelines aren’t very bad

[@OmegaDiagnostic-q1m]

wpw will cause v fib

[@souradipghosh7365]

First we should HUTT test

[@clarebonnar3281]

This proposrd methodology, advocating seeking only 3 niche ECG abnormalities (ie) long-QT, WPW & Brugada - each if which is very rare - misses the key, known fact that the majority of maignant ventricular arrhythmias do not occur in these contexts. Rather, they occur in patients with coronary artery disease or left ventricular abnormalities, such as LVH, previous infact scar, impaired LV function etc. These may all manifest on an ECG & therefore should be sought & if present, the patient should be referred for an outpatient echo.

[@chasepennel2148]

He mentioned that’s for healthy young people only. Anyone with established CAD obviously goes for urgent referral in the episode of syncope

[@wenyicvs]

True. Most carotid scan are meaningless.

[@holyearth]

He contradicts himsef

[@libyaup1205]

thankyou

[@mariamessina550]

🙏🙏🙏🙏🙏

[@dr.ashraf2015]

Long Qt , wpw, afib, vtach ,

[@lifeofresilience]

This was so enlightening 🙏🥲🤍 Thank you so much for caring about finding those special cases that most doctors continue to overlook because we are “young” and “look healthy” and because they didn’t “catch anything on that ekg that one time” 🙏❤️‍🩹 Thank you for this. I pray may God help the doctors to truly discover and help me with my heart health issues and syncope, and everyone else out there too 🙏🥺❤️‍🩹

[@cobybryson6668]

I Cody William Bryson of Irving Dallas County Texas USA 🇺🇸 have quit smoking cigarettes and cigars and I've quit drinking alcohol too. I have mid - late stage COPD and I'm on OXYGEN and Steroids and Breztri and albuterol inhalers and Tylenol 3 with codine pain pills just in case I have a COPD attack and just in case my stomach bloats up and my lower stomach stars hurting and I start pooping and peeing blood again. I need my pain pills for when I have COPD attacks and when my guts bloat again and I start peeing and pooping blood which burns like hell when I start peeing and pooping blood again. Just in the past two weeks I Cody William Bryson of Irving Dallas County Texas USA 🇺🇸 have started to get dizzy and blacking out and with my ears ringing and blurred vision and feeling like I am going to faint. Susan Marie Holloway Bryson baby my love 😍 XOXO ❤