晕厥症状的诊断和分析.pptxVIP

晕厥症状的诊断和分析; In some forms of syncope there may be a premonitory warning of an impending syncopal event, in another loss of consciousness occurs without warning. Recovery from syncope is usually accompanied by almost immediate restoration of appropriate behaviour and orientation. Retrograde amnesia, although believed to be uncommon, may be more frequent than previously thought, particularly in older individuals. Sometimes the post-recovery period may be marked by fatigue. Typical syncopal episodes are brief and usually they last nolonger than 20 s. ;;晕厥的概念;1、Neurally-mediated reflex syncopal Syndromes 2、Orthostatic 3、Cardiac arrhythmias as primary cause 4、 Structural cardiac or cardiopulmonary disease 5、Cerebrovascular;;Causes of syncope; 2、Cardiac arrhythmias as primary cause Structural cardiac or cardiopulmonary Cerebrovascular 3、 Vascular steal syndromes 4、Volume depletion ;Causes of non-syncopal attacks (commonly misdiagnosed as syncope);非晕厥发作的原因（通常误诊为晕厥）;晕厥的病因与临床表现;Neurally-mediated reflex syncopal syndromes;;神经调节性（神经反射性）;; (一)血管抑制性晕厥的临床表现;　　　发生血管抑制性晕厥的原因,可能是由于各种刺激 ( 疼痛、情绪紧张、恐惧、轻微出血等,在天气闷热、空气污浊、疲劳、空腹、失眠及妊娠等情况更易发生 )　通过迷走神经反射,引起短暂的身体血管床的扩张,外周血管阻力降低,回心血量减少,因而心输出量减少,血压下降,导致暂时性广泛性脑血流量减少所致 ;Orthostatic Autonomic failure;直立位低血压; (二)　直立性低血压; (二)　直立性低血压;（三）颈动脉窦综合征;（三）颈动脉窦综合征;（三）颈动脉窦综合征; (四) 排尿性晕厥; (四) 排尿性晕厥;(五)仰卧位低血压综合征; (六) 舌咽神经痛所致的晕厥; (七) 咳嗽晕厥;Cardiac arrhythmias as primary cause;占首位原因的心律失常;心原性晕厥; (一) 阵发性心动过速、阵发性心房纤颤; (二) 病态窦房结综合征 ;Structural cardiac or cardiopulmonary disease;器质性心脏或心肺疾病;(三) 主动脉瓣狭窄; (四) 先天性心脏病某些类型; (五) 原发性心肌病; (七) 左房粘液瘤、左心房血栓形成;; 血管疾病; 血管疾病; 血管疾病; (一) 脑动脉粥样硬化; (三) 短暂性脑缺血发作; (三) 短暂性脑缺血发作; (四) 多发性大动脉炎 ( 无脉症 );七. (五) 慢性铅毒性脑病;; 血液成分异常; ( 一) . 低血糖状态 .; ( 二) . 过度换气综和症; ( 三). 重症贫血 ;Important historical features;问诊要点;Questions about onset of attack Nausea, vomiting, abdominal discomfort, feeling of cold, sweating, aura, pain in neck or shoulders, blurred vision Questions about attack (eyewitness) Way of falling (slumping or kneeling o