Underlying diseases in syncope of children in China

Abstract

SummaryBackgroundSyncope accounts for about 1–2% of emergency department visits, but the etiology in many patients with syncope is unclear. Recently, with the use of the head-up tilt test (HUT), the number of patients with unexplained syncope (UPS) has been decreasing; however, the spectrum of underlying diseases of syncope in children is unclear. This retrospective study aimed to analyze the spectrum of underlying diseases in children with syncope.Material/MethodsThis multi-center clinical study consisted of 888 children (417 males, 471 females, aged 5–18 yrs, median age 12.0±3.0 yrs) with syncope who came from Beijing city, Hunan province, Hubei province and Shanghai from August 1999 to March 2009. The clinical and laboratory data of children were studied and the spectrum of underlying diseases in children with syncope was analyzed.ResultsIn 888 children with syncope, 175 (19.7%) had vasovagal syncope (VVS) with vasoinhibitory response, 35 (3.9%) had VVS with cardioinhibitory response, 73 (8.2%) had VVS with mixed response, 286 (32.2%) had postural orthostatic tachycardia syndrome (POTS), 19 (2.1%) had orthostatic hypotension, 7 (0.9%) had situational syncope, 13 (1.5%) had cardiogenic syncope, and 280 (31.5%) had unexplained syncope.ConclusionsThe data suggest that neurally-mediated syncope was the most common cause in children with syncope. POTS and VVS were the most common hemodynamic patterns of neurally-mediated syncope.

Postural Orthostatic Tachycardia Syndrome with Increased Erythrocytic Hydrogen Sulfide and Response to Midodrine Hydrochloride

“…However, in future studies, we need to investigate the diagnostic value in children of different ages and sex. In the present study, we reported on a relatively young group of children having POTS, which was in accordance with the published information in some references, 15,[29][30][31][32][33] although POTS often occurs in adolescents and adults. There are few studies indicating the standard dose of midodrine in pediatric medicine.…”

Epidemiological Characteristics and Clinical Outcome of Syncope in Children; A Report from Shiraz, Iran

“…The results of the present study showed that syncope was (15,(20)(21)(22). All the above-mentioned studies revealed the increased female prevalence of syncope in adolescents.…”

2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

“…Although V VS is the most common cause of pediatric syncope, cardiac syncope does represent 1.5% to 6% of pediatric cases (usually defined as up to 18 years of age). 617,619,620,629,631,632 Characteristics of presenting signs and symptoms differentiating V VS from cardiac causes of syncope are generally similar to those in adults. A family history of V VS and early SCD should be sought.…”