11/7/24, 8:03 PM Case Study: Ethan
Name: Jamie Morris
History of Present lliness (HPI)
Question 1
What questions will you ask Luke and his mother to understand his iliness?
Syncope Correct
Near syncope
Sejzure
Question 2
Describe in detail the etiology of syncope, including benign causes,
neurocardiogenic syncope, and cardiac causes.
~ )
Syncope is defined as a transient loss of consciousness (TLOC) due
to reduced perfusion to the brain (Stewart et al., 2023). There may
or may not be associated musculoskeletal movements, changes in
tone, and/or change of skin color (Stewart et al., 2023). It is for
these reasons that TLOC or syncopal episodes can easily be
mistaken for epileptic spells, and vice versa (Stewart et al., 2023).
Causes of syncope can include benign reasons such as vasovagal
syncope (VVS), orthostatic hypertension, or postural orthostatic
tachycardia syndrome (POTS) (Stewart et al., 2023). Pathological
syncope is usually the result of cardiac causes such as arrhythmias
or structural defects of the heart (Stewart et al., 2023).
https://Imscontent.embanet.com/Media/MVU/NURS654 C/NURS654C-w11-m02/ 1/9
, 11/7/24, 8:03 PM Case Study: Ethan
Neurocardiogenic syncope, especially VVS, causes include
environmentally triggers such as heat intolerance, periods of long
standing, intense pain and fear, dehydration, hypovolemia due to
intense vomiting or diarrhea, stress and/or hyperventilation
(Stewart et al., 2023). VVS is the most common form of syncope in
pediatrics, with a 2:1 ratio of occurrence in females over males
(Stewart et al., 2023). Neurocardiogenic syncope is often benign
and causes short-lasting effects and is not usually associated to
pathological conditions that warrant further investigation or
treatments (Stewart et al., 2023).
Cardiac syncope is a more severe form of syncope due to
circulatory changes or stagnation and carries the highest risk
factors, often because the cardiac involvement is either
arrnythmia based or structural defect-based (Stewart et al., 2023).
Changes in conduction of the heart must be addressed
immediately and further diagnostics will be required to determine
cause of heart-related syncope (Stewart et al., 2023).
Other syncope may be related to neurological causes such as
seizures, metabolic changes, drug-related effects, or neuro-
behavioral causes.
Reference:
Stewart,J. M., van Dijk,J. G., Balaji, S., & Sutton, R. (2023). A
framework to simplify paediatric syncope diagnosis. European
Journal of Pediatrics, 182(11), 4771-4780. https://doi-
org.proxy.library.maryville.edu/10.1007/s00431-023-05114-w
_ J
Question 3
What are red flags that indicate a cardiac evaluation?
4 3
Red flags would include familial history of cardiac defects,
structural anomalies, or arrhythmias (Stewart et al., 2023). No
environmental triggers such as extreme heat, sweating, etc.
https://Imscontent.embanet.com/Media/MVU/NURS654C/NURS654C-w11-m02/ 2/9
Name: Jamie Morris
History of Present lliness (HPI)
Question 1
What questions will you ask Luke and his mother to understand his iliness?
Syncope Correct
Near syncope
Sejzure
Question 2
Describe in detail the etiology of syncope, including benign causes,
neurocardiogenic syncope, and cardiac causes.
~ )
Syncope is defined as a transient loss of consciousness (TLOC) due
to reduced perfusion to the brain (Stewart et al., 2023). There may
or may not be associated musculoskeletal movements, changes in
tone, and/or change of skin color (Stewart et al., 2023). It is for
these reasons that TLOC or syncopal episodes can easily be
mistaken for epileptic spells, and vice versa (Stewart et al., 2023).
Causes of syncope can include benign reasons such as vasovagal
syncope (VVS), orthostatic hypertension, or postural orthostatic
tachycardia syndrome (POTS) (Stewart et al., 2023). Pathological
syncope is usually the result of cardiac causes such as arrhythmias
or structural defects of the heart (Stewart et al., 2023).
https://Imscontent.embanet.com/Media/MVU/NURS654 C/NURS654C-w11-m02/ 1/9
, 11/7/24, 8:03 PM Case Study: Ethan
Neurocardiogenic syncope, especially VVS, causes include
environmentally triggers such as heat intolerance, periods of long
standing, intense pain and fear, dehydration, hypovolemia due to
intense vomiting or diarrhea, stress and/or hyperventilation
(Stewart et al., 2023). VVS is the most common form of syncope in
pediatrics, with a 2:1 ratio of occurrence in females over males
(Stewart et al., 2023). Neurocardiogenic syncope is often benign
and causes short-lasting effects and is not usually associated to
pathological conditions that warrant further investigation or
treatments (Stewart et al., 2023).
Cardiac syncope is a more severe form of syncope due to
circulatory changes or stagnation and carries the highest risk
factors, often because the cardiac involvement is either
arrnythmia based or structural defect-based (Stewart et al., 2023).
Changes in conduction of the heart must be addressed
immediately and further diagnostics will be required to determine
cause of heart-related syncope (Stewart et al., 2023).
Other syncope may be related to neurological causes such as
seizures, metabolic changes, drug-related effects, or neuro-
behavioral causes.
Reference:
Stewart,J. M., van Dijk,J. G., Balaji, S., & Sutton, R. (2023). A
framework to simplify paediatric syncope diagnosis. European
Journal of Pediatrics, 182(11), 4771-4780. https://doi-
org.proxy.library.maryville.edu/10.1007/s00431-023-05114-w
_ J
Question 3
What are red flags that indicate a cardiac evaluation?
4 3
Red flags would include familial history of cardiac defects,
structural anomalies, or arrhythmias (Stewart et al., 2023). No
environmental triggers such as extreme heat, sweating, etc.
https://Imscontent.embanet.com/Media/MVU/NURS654C/NURS654C-w11-m02/ 2/9
