Emergency Medical Technician (EMT) Intermediate Practice Exam

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What is the most likely cause of a syncopal episode in a patient presenting with bradycardia?

  1. Hypoglycemia

  2. Acute bradycardia

  3. Dehydration

  4. Cardiogenic shock

The correct answer is: Acute bradycardia

Bradycardia, which is defined as a slower than normal heart rate, can lead to inadequate blood flow and oxygen delivery to the brain. When the heart is unable to maintain sufficient cardiac output due to a significantly reduced heart rate, it can result in a syncopal episode, or fainting. In this scenario, the acute nature of bradycardia contributes directly to the loss of consciousness, as the insufficient blood flow compromises cerebral perfusion. While other factors such as hypoglycemia, dehydration, and cardiogenic shock can contribute to syncopal events, they do not specifically address the immediate physiological impact of acute bradycardia. For example, hypoglycemia affects blood sugar levels but may not directly result in a syncopal episode unless it reaches a dangerously low level. Similarly, dehydration can lead to hypotension, but the immediate cause would be related to volume depletion rather than specifically to heart rate. Cardiogenic shock usually implies a broader context of heart failure, with multiple underlying causes, whereas acute bradycardia points to a specific heart rhythm issue that directly results in decreased cerebral perfusion. Therefore, when bradycardia occurs acutely, it is considered the most likely cause of a syncopal episode because it directly disrupts adequate