Differential Diagnosis for Syncope with a Sensation of Significant Warmth
- Single most likely diagnosis + Vasovagal syncope: This condition is the most common cause of syncope and is often preceded by a prodrome that can include a sensation of warmth, nausea, sweating, and palpitations. The warmth is thought to be due to vasodilation.
- Other Likely diagnoses + Anxiety or panic attack: These conditions can cause a sensation of warmth or flushing, as well as palpitations, shortness of breath, and lightheadedness, which can lead to syncope. + Orthostatic hypotension: This condition can cause lightheadedness and syncope upon standing, and some patients may experience a sensation of warmth due to decreased blood flow to the brain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.) + Cardiac arrhythmias (e.g. ventricular tachycardia): Certain arrhythmias can cause syncope and may be preceded by a sensation of warmth or palpitations. These conditions can be life-threatening if not promptly diagnosed and treated. + Pulmonary embolism: Although less common, a pulmonary embolism can cause syncope and may be preceded by a sensation of warmth or flushing due to the release of inflammatory mediators.
- Rare diagnoses + Pheochromocytoma: This rare tumor can cause episodic hypertension, palpitations, sweating, and flushing, which can lead to syncope. The sensation of warmth is due to the release of catecholamines. + Carotid sinus syncope: This condition is caused by an exaggerated response to carotid sinus baroreceptor stimulation, which can lead to syncope and may be preceded by a sensation of warmth or flushing.