Advanced Patient Assessment Practice Exam

Cough syncope is most often associated with which type of patient?

1. Pregnant women

2. Older obese men with diabetes

3. Middle-aged men with underlying COPD

4. Children with asthma

The correct answer is: Middle-aged men with underlying COPD

Cough syncope is most often associated with middle-aged men who have underlying chronic obstructive pulmonary disease (COPD). This phenomenon occurs due to the intense coughing that can lead to a transient drop in blood flow to the brain, resulting in fainting or syncope. In patients with COPD, episodes of coughing can be triggered by exacerbations of their condition, leading to increased intrathoracic pressure that affects venous return and decreasing cardiac output. Patients with COPD often have compromised respiratory function, which can exacerbate syncope when significant coughing occurs. The physiological mechanism involves a reflex where severe coughing leads to increased vagal tone, which can slow heart rate and lower blood pressure, contributing to episodes of syncope. Therefore, the demographic of middle-aged men with COPD makes them more susceptible to this specific type of syncope. This understanding of cough syncope emphasizes the importance of recognizing patients at higher risk and managing their underlying conditions effectively to prevent such episodes.