Current approaches to the clinical assessment of syncope in pediatric population

Bayram, Ayşe Kaçar; Pamukçu, Özge; Per, Hüseyin

doi:10.1007/s00381-015-2988-8

Cited by 12 publications

(15 citation statements)

References 59 publications

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“…Although most studies are carried out in adults, its safe use has been documented in the pediatric population 10 . This test should not be used with the purpose to induce or assess the response to pharmacological or interventional treatment in the patient with VVS due to low reproducibility of the test for triggering the same hemodynamic response in a second test 2,6 .…”

Section: Head-up-tilt-testmentioning

confidence: 99%

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Pediatric patients’ head-up-tilt-test with pharmacological challenge, it is safe?

García

Bustillos-García

Rivera-Roodríguez

2020

ACME

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Syncope in pediatrics represents an important cause of visits to the emergency units. For this reason, excluding a cardiac or malignant origin is essential at the time of the initial approach to determine what is the next step in management, or if they need to be referred to a pediatric cardiologist and/or electrophysiologist. Vasovagal syncope is the most frequent cause of syncope in pediatrics, in which a detailed clinical history is enough to make the diagnosis. If no diagnosis is concluded by the history, or if it is necessary to define the hemodynamic response of the patients, the head-up-tilt-test is indicated; this will trigger syncope due to an orthostatic stress caused by the angulated table (passive phase). If a negative response remains, it can be followed by a pharmacologic challenge to trigger the hemodynamic response, which is still controversial in pediatrics. The pharmacologic challenge increases the sensitivity with a slight reduction in test specificity. Although there is not a specific drug for the challenge in pediatric patients yet, the most commonly drugs used are nitrates and isoproterenol, the latter related to a great number of adverse effects. Sublingual administration of nitrates in the challenge has been proven to be ideal, effective, and safe in this specific age group. The aim of this article is to make a literature search to demonstrate the effectiveness and safety of the pharmacologic challenge during the head-up-tilt-test in pediatrics, emphasizing a study conducted at the National Institute of Cardiology with isosorbide dinitrate.

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Section: Head-up-tilt-testmentioning

confidence: 99%

“…Among the causes of syncope, vasovagal etiology affects 15%-25% of children and adolescents and is the most common cause of syncope in the pediatric population (61-80% of cases 5,6 ).…”

Section: Introductionmentioning

confidence: 99%

Pediatric patients’ head-up-tilt-test with pharmacological challenge, it is safe?

García

Bustillos-García

Rivera-Roodríguez

2020

ACME

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“…A typical syncope lasts for a few minutes and the child rapidly regains consciousness. In an epileptic seizure, blurred consciousness and stupor mostly continue in the postictal period (28,29).…”

Section: A Vasovagal Syncopementioning

confidence: 99%

“…It may be observed in any condition in which cardiac output is reduced in association with bradycardia or tachyarrhythmia. Aortic stenosis, hypertrophic cardiomyopathy, coronary artery anomalies, arrhythmias (Wolf-Parkinson-White syndrome, congenital AV block, long QT syndrome), postoperative conduction problems, myocarditis, Marfan syndrome, hypertension, and aortic dissection are cardiovascular causes that may lead to syncope (28). In these patients, echocardiography and 24-hour rhythm Holter recording are the most important diagnostic tools.…”

Section: A Vasovagal Syncopementioning

confidence: 99%

“…A systolic blood pressure lower than 90 mm Hg or a reduction more than 20 mm Hg suggests orthostatic hypotension. Anemia, excessive sweating, blood loss, conditions that may cause hypovolemia (diarrhea, dehydration), drugs that may affect the orthostatic reflex (phenothiazines, sedatives, nitrates, antidepressants, antihypertensive drugs, calcium channel blockers) may lead to orthostatic syncope (28,30).…”

Section: Orthostatic Hypotensionmentioning

confidence: 99%

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Non epileptic paroxysmal events in childhood

Tatlı

Güler

2017

Turk Pediatri Ars

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Non epileptic paroxysmal events are recurrent movement disorders with acute onset and ending, which may mimic epilepsy. The duration, place, timing of the attacks, and state of conciousness may confuse pediatricians about the diagnosis of epilepsy and non epileptic paroxysmal events. The key point in the diagnosis is taking an accurate and detailed history. Wrong diagnosis can give rise to anxiety of both the family and the child, interruptions in the child's education, limitations in career planning, and irreversible damages in the long term. The diagnosis can prevent unnecessary drug use and psychological damage. This review aims to discuss the clinical findings, treatment, and differential diagnoses of non epileptic paroxysmal events, and to increase awareness about non epileptic paroxysmal events among pediatricians. (Turk Pediatri Ars 2017; 52: 59-65)

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Child with Syncope

Rivera

Gayanilo²,

Swati³

2022

Symptom-Based Approach to Pediatric Neurology

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Current approaches to the clinical assessment of syncope in pediatric population

Abstract: The aim of this article is to present different types of syncope and to provide new practical clinical approaches to the diagnosis, investigation, and management in the pediatric population.

Cited by 12 publications

References 59 publications

Pediatric patients’ head-up-tilt-test with pharmacological challenge, it is safe?

Pediatric patients’ head-up-tilt-test with pharmacological challenge, it is safe?

Non epileptic paroxysmal events in childhood

Child with Syncope

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