Syncope symptom

Immunologic Acute reactions to first or second infusions of liposomal DOX have been documented. The symptoms were chest or throat tightness, pruritus, rash, tachycardia, flushing, shortness of breath, swelling, headache, chills, chest pain, and, in rare cases, cyanosis, apnoea and syncope. Symptoms occur in less than 1% but severe reactions usually require discontinuahon. Desensitisahon of severe reactions has been described in six patients where the sensitivity is possibly due to the liposomal preparation [76 j. 

Cardiac arrhythmias are an important cause of morbidity and mortality approximately 400,000 people per year die from myocardial infarctions (MI) in the United States alone. Individuals with MI exhibit some form of dysrhythmia within 48 h. Post-mortem examinations of MI victims indicate that many die in spite of the fact that the mass of ventricular muscle deprived of its blood supply is often quite small. These data suggest that the cause of death is ventricular fibrillation and that the immediate availability of a safe and efficacious antiarrhythmic agent could have prolonged a number of Hves. The goals of antiarrhythmic therapy are to reduce the incidence of sudden death and to alleviate the symptoms of arrhythmias, such as palpitations and syncope. Several excellent reviews of the mechanisms of arrhythmias and the pharmacology of antiarrhythmic agents have been pubflshed (1,2). 

Some patients with mastocytosis report flushing, shortness of breath, palpitations, nausea, diarrhea, hypotension or even syncope [9, 24]. Lethargy and fatigue lasting several hours may follow. Gastrointestinal complaints are common in patients with SM [9, 24]. Abdominal pain is the most frequent symptom, followed by nausea. 

Symptoms of bradyarrhythmias include dizziness, fatigue, lightheadedness, syncope, chest pain (in patients with underlying myocardial ischemia), and shortness of breath and other symptoms of heart failure (in patients with underlying left ventricular dysfunction). 

Symptoms typical of tachyarrhythmias include palpitations, dizziness, lightheadedness, shortness of breath, chest pain (if underlying CAD is present), near-syncope, and syncope. Patients commonly complain of palpitations often the complaint is "I can feel my heart beating fast" or "It feels like my heart is going to beat out of my chest."... 

The majority of patients who experience simple or complex VPDs are asymptomatic. Occasionally, patients with complex or frequent VPDs may experience symptoms of palpitations, lightheadedness, fatigue, near-syncope or syncope. 

The symptoms produced by respiratory alkalosis result from increased irritability of the central and peripheral nervous systems. These include light-headedness, altered consciousness, distal extremity paresthesias, circumoral paresthesia, cramps, carpopedal spasms, and syncope. Various supraventricular and ventricular cardiac arrhythmias may occur in extreme cases, particularly in critically ill patients. An additional finding in many patients with severe respiratory alkalosis is hypophosphatemia, reflecting a shift of phosphate from the extracellular space into the cells. Chronic respiratory alkalosis is generally asymptomatic. 

If the patient is started on an a-adrenergic antagonist, monitor the patient for hypotension, dizziness, or syncope. If present, assess the severity of each symptom. Reduce the drug dose or discontinue the drug, as necessary. If the patient has malaise or rhinitis, reassure the patient that these are usual, but bothersome, adverse effect, that often improve with continued therapy. 

The group C counterirritants methyl nicotinate and histamine dihydrochloride produce vasodilation.24 Methyl nicotinate is a nicotinic acid derivative that produces prostaglandin-mediated vasodilation.46 NSAIDs and aspirin block the production of prostaglandins and decrease methyl nicotinate-induced vasodilation. Application over a large area has been reported to cause systemic symptoms and syncope, possibly due to vasodilation and a decrease in blood pressure.47 Patients should be educated to apply only scant amounts to the affected area to avoid this effect. 

The answer is g. (Hardman, p 870. Katzung, pp 230-231) Quini-dine causes prolongation of the QT interval at therapeutic doses, possibly because of its anti muscarinic actions In some patients, this is associated with recurrent lightheaded ness and fainting (known as qmmdine syncope). The symptoms result from torsades de pointes. They typically terminate but may become fatal by degeneration into ventricular fibrillation. 

Rey and coworkers78 reported methyltin intoxication in six chemical workers exposed to Me2SnCl2 and MesSnCI. After a latent period of 1 -3 days, the first symptoms occurred, including headache, tinnitus, deafness, impair of memory, disorientation, aggressiveness, psychotic behavior, syncope, loss of consciousness and, in the most severe cases, respiratory depression requiring ventilatory assistance. Increased tin excretion was detected in the urine of all patients, particularly those most ill. The patient with the highest tin levels died 12 days after the initial exposure. 

Supraventricular tachycardias may cause a variety of clinical manifestations ranging from no symptoms to minor palpitations and/or irregular pulse to severe and even life-threatening symptoms. Patients may experience dizziness or acute syncopal episodes symptoms of HF anginal chest pain or, more often, a choking or pressure sensation during the tachycardia episode. 

AF or atrial flutter may be manifested by the entire range of symptoms associated with other supraventricular tachycardias, but syncope is not a common presenting symptom. An additional complication of AF is arterial embolization resulting from atrial stasis and poorly adherent mural thrombi, which accounts for the most devastating complication embolic stroke. Patients with AF and concurrent mitral stenosis or severe systolic HF are at particularly high risk for cerebral embolism. 

PVCs often cause no symptoms or only mild palpitations. The presentation of VT may vary from totally asymptomatic to pulseless hemodynamic collapse. Consequences of proarrhythmia range from no symptoms to worsening of symptoms to sudden death. VF results in hemodynamic collapse, syncope, and cardiac arrest. 

Patients with bradyarrhythmias experience symptoms associated with hypotension such as dizziness, syncope, fatigue, and confusion. If LV dysfunction exists, symptoms of congestive HF may be exacerbated. 

The most frequent adverse effects are mild to moderate GI symptoms (nausea, vomiting, and diarrhea), urinary incontinence, dizziness, headache, syncope, bradycardia, muscle weakness, salivation, and sweating. Abrupt discontinuation can cause worsening of cognition and behavior in some patients. 

Advise patients that initiation of treatment and (to a lesser extent) dosage increases may be associated with transient symptoms of dizziness or lightheadedness (and rarely syncope) within the first hour after dosing. Thus, during these periods, avoid situations such as driving or hazardous tasks, where symptoms could result in injury. In addition, vasodilatory symptoms often do not require treatment, but it may be useful to separate the time of dosing of carvedilol from that of the ACE inhibitor or to temporarily reduce the dose of the ACE inhibitor. Do not increase the dose of carvedilol until symptoms of worsening heart failure or vasodilation have been established. 

Peripheral vascular disease -blockers can precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. Exercise caution. Hypotension and postural hypotension Hypotension and postural hypotension occurred in 9.7% and syncope in 3.4% of CHF patients receiving carvedilol, compared with 3.6% and 2.5% of placebo patients, respectively. The risk for these events was highest during the first 30 days of dosing. 

QT prolongation, recent acute Ml, uncompensated heart failure, cardiac arrhythmia). Discontinue treatment if the QT interval is over 500 msec. Patients who experience symptoms that may be associated with the occurrence of torsade de pointes (eg, dizziness, palpitations, syncope) may warrant further cardiac evaluation in particular, consider Holter monitoring. 

CA/S-Agitation, akathesia, akinesia, anxiety, asthenia, confusion, convulsions, dizziness, drowsiness, dystonia, extrapyramidal symptoms, gait abnormal, headache, hypokinesia, insomnia, libido decreased, light-headedness, restlessness, somnolence, syncope, tardive dystonia, tremor, vertigo. 

Adverse reactions occurring in 3% or more of patients include the following Dizziness headache insomnia confusion depression anxiety somnolence hallucination tremor aggressive reaction nausea vomiting diarrhea anorexia abdominal pain dyspepsia constipation flatulence accidental trauma fatigue urinary tract infection asthenia malaise rhinitis increased sweating hypertension influenza-like symptoms syncope weight decrease. 

Hypotension/Syncope Dopaminergic therapy in patients with Parkinson s disease has been associated with orthostatic hypotension. Entacapone enhances levodopa bioavailability and, therefore, might be expected to increase the occurrence of orthostatic hypotension. However, in entacapone clinical trials, no differences from placebo were seen for measured orthostasis or symptoms of orthostasis. 

The symptom of syncope in a patient with ischemic heart disease and heart failure should initially prompt concern about ventricular dysrhythmias. Based on the results of recent clinical trials of sudden death prevention in heart failure [27, 28], most patients with low ejection fraction and advanced ischemic heart disease will likely be treated with an... 

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