Pediatr. praxi. 2007;8(5):259-262

Syncope in children

MUDr. Štěpán Rucki CSc

Dětské oddělení nemocnice s poliklinikou, Třinec

Syncope is a relatively frequent problem in population of older school children and adolescents. Some of the more common causes of syncope in childhood are demonstrated on five case reports. Vasovagal syncope is the most frequently reported syncope in otherwise healthy children and adolescents. It has benign character and good prognosis. Cardiac disease is a rather rare cause of syncope in children but endangers the patient with risk of sudden death. In differential diagnostic approach to syncope it is necesery to rule out other causes as neurologic, psychiatric and metabolic diseases. In all patients with syncope careful history should be obtained and physical examination and 12-lead ECG should be performed. Special attention should be paid to the patients with syncope during physical exercise and with other signs of potential cardiac disease such as palpitation or chest pain. Specialized cardiologic tests such as 24-hour ECG monitoring, echocardiography, exercise testing or electrophysiologic studies are indicated in these cases. Head-up tilt table testing (HUTT) is eligible in patients with recurrent episodes of syncope. Neurologic examination including EEG should precede this test. Treatment of syncope depends on the cause. Non-pharmacologic approach and education is preferred in patients with vasovagal syncope. Pharmacologic treatment is rarely indicated in cases resistant to non-pharmacologic approach and should be prescribed only after careful examination of the patient.

Keywords: syncope in children, vasovagal syncope, cardiac syncope, head-up tilt table test, postural orthostatic tachycardia syndrome

Published: December 1, 2007  Show citation