Advances in medical sciences · 2013
Syncope in children and adolescents living in north-eastern Poland - scope of causes.
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Baran M, Szczepanski W, Bossowski A
Аннотация
PURPOSE: To investigate the diagnostic yield of different tests and asses the scope of causes in children referring to the hospital with a syncope in north-eastern Poland.
METHODS: A review of 386 consecutive patients (age 2-18 years) living in north-eastern Poland presenting to the cardiology department with a new onset syncope (which appeared to be neurally mediated by history) was undertaken. The patients underwent physical examination, laboratory tests, electrocardiography, 24-holter monitoring, head-up tilt-test, exercise test, echocardiography and electroencephalography. All the tests were performed in most of the patients, without ending the diagnostics after finding the first probable cause of loss of consciousness.
RESULTS: 229 potential causes of syncope were found in 191 patients (49.4%), with 2 possible causes in 32 patients and 3 potential causes in 3 patients. The top 3 tests with the highest diagnostic yield were: head-up tilt test (41.4%), 24-holter monitoring (14.5%) and echocardiography (8.4%). Electroencephalography was useful in 3 patients (1.5%) and exercise test did not help in any patient.
CONCLUSION: In some children more than one potential cause of syncope was diagnosed. That might confirm multiple factors' causality of syncope. Head-up tilt-test has the highest diagnostic yield in children with syncope. If the diagnostic protocol is not very strict, one might find some crucial conditions in about 8.3% of patients.
METHODS: A review of 386 consecutive patients (age 2-18 years) living in north-eastern Poland presenting to the cardiology department with a new onset syncope (which appeared to be neurally mediated by history) was undertaken. The patients underwent physical examination, laboratory tests, electrocardiography, 24-holter monitoring, head-up tilt-test, exercise test, echocardiography and electroencephalography. All the tests were performed in most of the patients, without ending the diagnostics after finding the first probable cause of loss of consciousness.
RESULTS: 229 potential causes of syncope were found in 191 patients (49.4%), with 2 possible causes in 32 patients and 3 potential causes in 3 patients. The top 3 tests with the highest diagnostic yield were: head-up tilt test (41.4%), 24-holter monitoring (14.5%) and echocardiography (8.4%). Electroencephalography was useful in 3 patients (1.5%) and exercise test did not help in any patient.
CONCLUSION: In some children more than one potential cause of syncope was diagnosed. That might confirm multiple factors' causality of syncope. Head-up tilt-test has the highest diagnostic yield in children with syncope. If the diagnostic protocol is not very strict, one might find some crucial conditions in about 8.3% of patients.
Предметные рубрики MeSH
AdolescentAnemiaAortic Valve StenosisCardiomyopathy, HypertrophicChildChild, PreschoolConversion DisorderDiabetes ComplicationsEchocardiographyElectrocardiography, AmbulatoryEpilepsy, GeneralizedExercise TestFemaleHeart DiseasesHumansMaleMitral Valve ProlapsePolandPulmonary Valve StenosisSyncopeTilt-Table Test