Dijagnosticiranje i liječenje sinkope

master's thesis

• Title (english): Diagnosis and management of syncope
• Author: Marija Svalina
• Mentor: Diana Delić-Brkljačić (mentor)
• Committee member: Matias Trbušić (predsjednik povjerenstva)
• Committee member: Martina Lovrić Benčić (član povjerenstva)
• Committee member: Diana Delić-Brkljačić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Sinkopa se definira kao nagli i privremeni gubitak svijesti uzrokovan prolaznom, globalnom hipoperfuzijom mozga. Za sinkopu su karakteristični brzi početak, kratko trajanje te spontani i potpuni oporavak svijesti. Uzroci sinkope su mnogobrojni te variraju od benignih stanja do životno ugrožavajućih bolesti. Prema etiologiji, sinkopa se dijeli na: refleksnu, kardiogenu, ortostatsku i cerebrovaskularnim poremećajima uzrokovanu sinkopu. Uzrok ostaje nepoznat u trećini slučajeva. Većina pacijenata je u trenutku pregleda asimptomatska, što predstavlja najveći izazov u evaluaciji pacijenta sa sinkopom. Inicijalna obrada se sastoji od uzimanja detaljne anamneze, fizikalnog pregleda i standardnog 12-kanalnog elektrokardiograma. Ovi postupci upućuju prema daljnjoj dijagnostičkoj evaluaciji te sprječavaju nepotrebna testiranja i neadekvatne terapijske postupke. U pacijenata sa suspektnom kardiogenom sinkopom indicirana je hospitalizacija dok se ne utvrdi uzrok. Suprotno tomu, ukoliko se sumnja na refleksnu ili ortostatsku sinkopu, dovoljna je vanbolnička obrada i praćenje po potrebi. Rizik od smrti je primarno određen težinom priležeće kardiovaskularne bolesti. Glavni ciljevi liječenja su prevencija ponovnih epizoda sinkope, fizičkih ozljeda te produljenje života, a izbor metode liječenja ovisi o etiologiji sinkope.

Abstract (english)

Syncope is defined as a sudden and temporary loss of consciousness due to global cerebral hypoperfusion. It is characterized by having a relatively rapid onset and brief duration with spontaneous and full recovery. Syncope may have multiple possible causes, ranging from benign conditions to life-threatening diseases. Syncope can be classified into four categories: reflex mediated, cardiac, orthostatic, and cerebrovascular. In approximately 30 percent of cases the patient is considered to have an unexplained diagnosis. The major challenge in the evaluation of patients with syncope is that most patients are asymptomatic at the time of their presentation. The initial evaluation of suspected syncope relies heavily on obtaining of a comprehensive history, performing a physical examination, and reviewing an electrocardiogram. These steps
should guide the subsequent diagnostic evaluation and help limit unnecessary testing and treatment. In patients with suspected cardiac syncope, monitoring is indicated until a diagnosis is made. In patients with suspected reflex syncope or orthostatic hypotension, outpatient evaluation is appropriate. The risk of death is primarily determined by the severity of underlying cardiovascular disease. The management of the patient with syncope is based upon the underlying cause of syncope. The principal goals of treatment are to prolong survival, limit physical injuries, and prevent recurrences.

• Keywords: sinkopa; dijagnosticiranje; liječenje
• Keywords (english): syncope; diagnosis; management
• Language: croatian
• URN:NBN: urn:nbn:hr:105:396575
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-11-22 13:16:00