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espanolLa perdida transitoria de conciencia (PTC) se define como una perdida del conocimiento, real o aparente, que se caracteriza por amnesia durante el periodo de inconsciencia, control motor anomalo, falta de respuesta y duracion corta. La historia clinica detallada en la evaluacion inicial de un paciente con episodio sincopal es clave y debe recoger los antecedentes personales y familiares, las circunstancias previas al episodio y caracteristicas del mismo, sintomas prodromicos y la informacion relativa al episodio habitualmente por un testigo presencial. Los hallazgos de la exploracion y los resultados de las pruebas complementarias completan la estrategia diagnostica que permitira establecer el diagnostico de sincope reflejo (neuromediado), por hipotension ortostatica o secundario a patologia cardiovascular. Hay una serie de entidades que cursan con PTC, que no estan causadas por hipoperfusion cerebral transitoria y que, por tanto, no deben considerarse como sincope. Es importante establecer el diagnostico diferencial en la evaluacion inicial en el Servicio de Urgencias. EnglishTransient 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. A detailed medical history in the initial evaluation of a patient with an episode of syncope is key. It must include a personal and family medical history; the circumstances prior to the episode; its characteristics; prodromal symptoms; and information regarding the episode, which are usually provided by a witness. The findings upon examination and results of additional tests are the final pieces of the diagnostic strategy that allow for establishing a diagnosis of reflex (neuromediated) syncope, syncope due to orthostatic hypertension, or syncope secondary to cardiovascular disease. There are a series of entities that progress with transient loss of consciousness that are not caused by transient cerebral hypoperfusion and which, therefore, must not be considered syncope. It is important to establish the differential diagnosis in the initial evaluation in the emergency department. |
