Abstract

Transient loss of consciousness (TLC) is defined as a real or apparent loss of consciousness that is characterized by amnesia during the period of unconsciousness, anomalous motor control, a lack of response, and short duration. The pathophysiological criteria define the different syncope groups. A drop in blood pressure, either due to low total peripheral resistance or low cardiac output, with the end result of cerebral hypoperfusion characterizes a syncopal episode. Syncope is classified in three groups based on the triggering etiology: reflex or neuromediated syncope, syncope due to orthostatic hypertension, or syncope secondary to cardiovascular pathology. The medical history, findings upon examination, and results of additional tests allow for identifying the etiology of the syncope in most cases and stratifying risk. In this update, we summarize the concept, pathophysiology, classification, diagnosis, treatment, and rules for action created by the European Society of Cardiology in their recent guidelines for patients with loss of consciousness and syncope.

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