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Synkopa je náhlá krátkodobá (několik sekund, max. několik desítek s) ztráta vědomí spojená s pádem a ochabnutím svalového tonusu.

Etiopatogeneze: patofyziologickou příčinou synkopy je náhlý kritický pokles (až přerušení) průtoku krve mozkem. Etiologicky jde buď o krátkou asystolii (při sick sinus syndromu, při intermitentním AV bloku III. stupně), nebo extrémní bradykardii + hypotenzi (vazovagální synkopa), vzácně o paroxyzmus maligní komorové arytmie:

Diagnóza: ztráta vědomí vzniká náhle, je provázena okamžitým pádem, procitnutí k plnému vědomí je po synkopě okamžité. Pokud je možnost vyšetřit nemocného v průběhu synkopy, obvykle nehmatáme žádný puls nebo je puls velmi slabý s bradykardií výrazně pod 30/min. Neurologický nález mimo synkopu je normální.

Terapie: jak vyplývá z definice synkopy. Lékař obvykle přichází k nemocnému po odeznění synkopy. Základem léčby je stanovení přesné diagnózy (etiologie). Proto se léčba zahajuje obvykle až v nemocnici (úprava event. rizikové medikace, trvalá kardiostimulace, antiarytmika, implantabilní defibrilátor). V prehospitalizační fázi se pouze zajistí krevní oběh a dýchání pro transport na kardiologické oddělení nemocnice. Je nutné monitorování EKG pěhem transportu a při recidivě synkopy event. cílená léčba.

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