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Presyncope

MedGen UID:
148578
Concept ID:
C0700200
Sign or Symptom
Synonym: Presyncopes
SNOMED CT: Near syncope (427461000); Presyncope (427461000)
 
HPO: HP:0031972

Definition

Presyncope is a state of lightheadedness, muscular weakness, blurred vision, and feeling faint. Presyncope is most often cardiovascular in cause. [from HPO]

Term Hierarchy

Conditions with this feature

Arrhythmogenic right ventricular dysplasia 5
MedGen UID:
346805
Concept ID:
C1858379
Disease or Syndrome
Arrhythmogenic right ventricular cardiomyopathy (ARVC) – previously referred to as arrhythmogenic right ventricular dysplasia (ARVD) – is characterized by progressive fibrofatty replacement of the myocardium that predisposes to ventricular tachycardia and sudden death in young individuals and athletes. It primarily affects the right ventricle, and it may also involve the left ventricle. The presentation of disease is highly variable even within families, and some affected individuals may not meet established clinical criteria. The mean age at diagnosis is 31 years (±13; range: 4-64 years).
Short QT syndrome type 3
MedGen UID:
400662
Concept ID:
C1865018
Disease or Syndrome
Short QT syndrome is a cardiac channelopathy associated with a predisposition to atrial fibrillation and sudden cardiac death. Patients have a structurally normal heart, but electrocardiography (ECG) exhibits abbreviated QTc (Bazett's corrected QT) intervals of less than 360 ms (summary by Moreno et al., 2015). For a discussion of genetic heterogeneity of short QT syndrome, see SQT1 (609620).
Familial cold autoinflammatory syndrome 3
MedGen UID:
482544
Concept ID:
C3280914
Disease or Syndrome
Familial cold autoinflammatory syndrome-3 is an autosomal dominant immune disorder characterized by the development of cutaneous urticaria, erythema, and pruritus in response to cold exposure. Affected individuals have variable additional immunologic defects, including antibody deficiency, decreased numbers of B cells, defective B cells, increased susceptibility to infection, and increased risk of autoimmune disorders (summary by Ombrello et al., 2012). For a discussion of genetic heterogeneity of FCAS, see FCAS1 (120100).
Brugada syndrome 9
MedGen UID:
903155
Concept ID:
C4225340
Disease or Syndrome
Brugada syndrome is characterized by cardiac conduction abnormalities (ST segment abnormalities in leads V1-V3 on EKG and a high risk for ventricular arrhythmias) that can result in sudden death. Brugada syndrome presents primarily during adulthood, although age at diagnosis may range from infancy to late adulthood. The mean age of sudden death is approximately 40 years. Clinical presentations may also include sudden infant death syndrome (SIDS; death of a child during the first year of life without an identifiable cause) and sudden unexpected nocturnal death syndrome (SUNDS), a typical presentation in individuals from Southeast Asia. Other conduction defects can include first-degree AV block, intraventricular conduction delay, right bundle branch block, and sick sinus syndrome.
Arrhythmogenic right ventricular dysplasia, familial, 14
MedGen UID:
1712001
Concept ID:
C5394505
Disease or Syndrome
Arrhythmogenic right ventricular cardiomyopathy/dysplasia-14 (ARVD14) is characterized by palpitations, chest pain, and presyncope. Electrocardiography shows epsilon waves, T-wave inversion across anterior leads, premature ventricular contractions, ventricular tachycardia, and left bundle branch block. Dilation of the right ventricle with hypokinesia and aneurysmal changes are seen on echocardiography. Cardiac MRI may show fibrofatty infiltration, which has been confirmed by endocardial biopsy in some patients. Sudden death may occur (Mayosi et al., 2017). For a discussion of genetic heterogeneity of ARVD, see ARVD1 (107970).

Professional guidelines

PubMed

Wieling W, Kaufmann H, Claydon VE, van Wijnen VK, Harms MPM, Juraschek SP, Thijs RD
Lancet Neurol 2022 Aug;21(8):735-746. doi: 10.1016/S1474-4422(22)00169-7. PMID: 35841911Free PMC Article
Marcus GM
Circulation 2020 Apr 28;141(17):1404-1418. Epub 2020 Apr 27 doi: 10.1161/CIRCULATIONAHA.119.042434. PMID: 32339046
Muncie HL, Sirmans SM, James E
Am Fam Physician 2017 Feb 1;95(3):154-162. PMID: 28145669

Recent clinical studies

Etiology

Wieling W, Kaufmann H, Claydon VE, van Wijnen VK, Harms MPM, Juraschek SP, Thijs RD
Lancet Neurol 2022 Aug;21(8):735-746. doi: 10.1016/S1474-4422(22)00169-7. PMID: 35841911Free PMC Article
Ahmed A, Pothineni NVK, Charate R, Garg J, Elbey M, de Asmundis C, LaMeir M, Romeya A, Shivamurthy P, Olshansky B, Russo A, Gopinathannair R, Lakkireddy D
J Am Coll Cardiol 2022 Jun 21;79(24):2450-2462. doi: 10.1016/j.jacc.2022.04.019. PMID: 35710196
Marcus GM
Circulation 2020 Apr 28;141(17):1404-1418. Epub 2020 Apr 27 doi: 10.1161/CIRCULATIONAHA.119.042434. PMID: 32339046
Brieler J, Breeden MA, Tucker J
Am Fam Physician 2017 Nov 15;96(10):640-646. PMID: 29431384
Runser LA, Gauer RL, Houser A
Am Fam Physician 2017 Mar 1;95(5):303-312. PMID: 28290647

Diagnosis

Marcus GM
Circulation 2020 Apr 28;141(17):1404-1418. Epub 2020 Apr 27 doi: 10.1161/CIRCULATIONAHA.119.042434. PMID: 32339046
Precone V, Krasi G, Guerri G, Madureri A, Piazzani M, Michelini S, Barati S, Maniscalchi T, Bressan S, Bertelli M
Acta Biomed 2019 Sep 30;90(10-S):32-43. doi: 10.23750/abm.v90i10-S.8755. PMID: 31577251Free PMC Article
Brieler J, Breeden MA, Tucker J
Am Fam Physician 2017 Nov 15;96(10):640-646. PMID: 29431384
Alboni P, Holz A, Brignole M
Heart 2013 Jul;99(13):904-8. Epub 2013 Jan 2 doi: 10.1136/heartjnl-2012-303220. PMID: 23286970
Post RE, Dickerson LM
Am Fam Physician 2010 Aug 15;82(4):361-8, 369. PMID: 20704166

Therapy

Wieling W, Kaufmann H, Claydon VE, van Wijnen VK, Harms MPM, Juraschek SP, Thijs RD
Lancet Neurol 2022 Aug;21(8):735-746. doi: 10.1016/S1474-4422(22)00169-7. PMID: 35841911Free PMC Article
Marcus GM
Circulation 2020 Apr 28;141(17):1404-1418. Epub 2020 Apr 27 doi: 10.1161/CIRCULATIONAHA.119.042434. PMID: 32339046
Batzner A, Schäfers HJ, Borisov KV, Seggewiß H
Dtsch Arztebl Int 2019 Jan 25;116(4):47-53. doi: 10.3238/arztebl.2019.0047. PMID: 30855006Free PMC Article
Webster R, Salam A, de Silva HA, Selak V, Stepien S, Rajapakse S, Amarasekara S, Amarasena N, Billot L, de Silva AP, Fernando M, Guggilla R, Jan S, Jayawardena J, Maulik PK, Mendis S, Mendis S, Munasinghe J, Naik N, Prabhakaran D, Ranasinghe G, Thom S, Tisserra N, Senaratne V, Wijekoon S, Wijeyasingam S, Rodgers A, Patel A; TRIUMPH Study Group
JAMA 2018 Aug 14;320(6):566-579. doi: 10.1001/jama.2018.10359. PMID: 30120478Free PMC Article
Brown SG
J Allergy Clin Immunol 2004 Aug;114(2):371-6. doi: 10.1016/j.jaci.2004.04.029. PMID: 15316518

Prognosis

Wieling W, Kaufmann H, Claydon VE, van Wijnen VK, Harms MPM, Juraschek SP, Thijs RD
Lancet Neurol 2022 Aug;21(8):735-746. doi: 10.1016/S1474-4422(22)00169-7. PMID: 35841911Free PMC Article
Hawks MK, Paul MLB, Malu OO
Am Fam Physician 2021 Aug 1;104(2):179-185. PMID: 34383451
Rocha EA, Mehta N, Távora-Mehta MZP, Roncari CF, Cidrão AAL, Elias Neto J
Arq Bras Cardiol 2021 Apr;116(4):814-835. doi: 10.36660/abc.20200420. PMID: 33886735Free PMC Article
Marcus GM
Circulation 2020 Apr 28;141(17):1404-1418. Epub 2020 Apr 27 doi: 10.1161/CIRCULATIONAHA.119.042434. PMID: 32339046
Alboni P, Holz A, Brignole M
Heart 2013 Jul;99(13):904-8. Epub 2013 Jan 2 doi: 10.1136/heartjnl-2012-303220. PMID: 23286970

Clinical prediction guides

Hawks MK, Paul MLB, Malu OO
Am Fam Physician 2021 Aug 1;104(2):179-185. PMID: 34383451
Marcus GM
Circulation 2020 Apr 28;141(17):1404-1418. Epub 2020 Apr 27 doi: 10.1161/CIRCULATIONAHA.119.042434. PMID: 32339046
Wells R, Spurrier AJ, Linz D, Gallagher C, Mahajan R, Sanders P, Page A, Lau DH
Vasc Health Risk Manag 2018;14:1-11. Epub 2017 Dec 29 doi: 10.2147/VHRM.S127393. PMID: 29343965Free PMC Article
Alboni P, Holz A, Brignole M
Heart 2013 Jul;99(13):904-8. Epub 2013 Jan 2 doi: 10.1136/heartjnl-2012-303220. PMID: 23286970
Brown SG
J Allergy Clin Immunol 2004 Aug;114(2):371-6. doi: 10.1016/j.jaci.2004.04.029. PMID: 15316518

Recent systematic reviews

Abdelazeem B, Abbas KS, Manasrah N, Amin MA, Mohammed SM, Mostafa MR
Complement Ther Clin Pract 2022 Aug;48:101579. Epub 2022 Apr 4 doi: 10.1016/j.ctcp.2022.101579. PMID: 35390588
Yin X, Tian F, Wu B, Xu T
Cochrane Database Syst Rev 2022 Mar 29;3(3):CD010893. doi: 10.1002/14651858.CD010893.pub4. PMID: 35349164Free PMC Article
Caldeira D, Rodrigues FB, Duarte MM, Sterrantino C, Barra M, Gonçalves N, Pinto FJ, Ferreira JJ, Costa J
Drug Saf 2018 Jan;41(1):77-86. doi: 10.1007/s40264-017-0586-2. PMID: 28786035
Silici S, Atayoglu AT
Food Chem Toxicol 2015 Dec;86:282-90. Epub 2015 Nov 10 doi: 10.1016/j.fct.2015.10.018. PMID: 26547022
Chen BW, Wang ZG, Lv NQ, Cheng YM, Dang AM
Clin Auton Res 2014 Jun;24(3):127-34. Epub 2014 Mar 29 doi: 10.1007/s10286-014-0238-x. PMID: 24682799

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