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Extra info for Gynecology and Obstetrics (2008 Edition) (Current Clinical Strategies)

Example text

It is useful in dissecting aortic aneurysm when beta-blockers are contraindicated; however, it is rarely used because most physicians are more familiar with nitroprusside. 3-3 mg/min IV infusion. References, see page 360. Syncope Syncope is the abrupt and transient loss of consciousness associated with absence of postural tone, followed by a rapid and complete recovery. It is most often benign and selflimited. However, syncope can be a premonitory sign of sudden cardiac death, especially in patients with organic heart disease.

Management of acute exacerbations A. High-dose, short-acting beta2 agonists delivered by a metered-dose inhaler with a volume spacer or via a nebulizer remains the mainstay of urgent treatment. B. Most patients require therapy with systemic corticosteroids to resolve symptoms and prevent relapse. Hospitalization should be considered if the PEFR remains less than 70% of predicted. Patients with a PEFR less than 50% of predicted who exhibit an increasing pCO2 level and declining mental status are candidates for intubation.

D. Bundle branch and/or fascicular block. e. Prolonged QT interval. 2. A prolonged QT interval on electrocardiogram may favor torsade de pointes as a possible underlying cause for syncope. Other possible causes of syncope that can be diagnosed from or suggested by the electrocardiogram include the Wolff-ParkinsonWhite syndrome, a myocardial infarction, chronic obstructive pulmonary disease, hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, and Brugada syndrome. B. Ambulatory monitoring for 24 to 48 hours or patient activated event recording is commonly obtained in the assessment of syncope.

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