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Different haemodynamic patterns in head-up tilt test on 400 paediatric cases with unexplained syncope

Published online by Cambridge University Press:  15 July 2014

Yilmaz Yozgat ,
Cem Karadeniz ,
Rahmi Ozdemir ,
Onder Doksoz ,
Mehmet Kucuk ,
Utku Karaarslan ,
Timur Mese  and
Nurettin Unal
Yilmaz Yozgat*
Affiliation:
Department of Pediatric Cardiology, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey
Cem Karadeniz
Affiliation:
Department of Pediatric Cardiology, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey
Rahmi Ozdemir
Affiliation:
Department of Pediatric Cardiology, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey
Onder Doksoz
Affiliation:
Department of Pediatric Cardiology, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey
Mehmet Kucuk
Affiliation:
Department of Pediatric Cardiology, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey
Utku Karaarslan
Affiliation:
Department of Pediatric Cardiology, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey
Timur Mese
Affiliation:
Department of Pediatric Cardiology, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey
Nurettin Unal
Affiliation:
Department of Pediatric Cardiology, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey
*
Correspondence to: Y. Yozgat, Department of Pediatric Cardiology, Dr. Behcet Uz Children’s Hospital, 1374 St. No. 11 Izmir, Turkey. Tel: +905058220788; Fax: +902324892315; E-mail: yozgatyilmaz@yahoo.com
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Abstract

Objective: To assess haemodynamic patterns in head-up tilt testing on 400 paediatric cases with unexplained syncope. Methods: Medical records of 520 children who underwent head-up tilt testing in the preceding year were retrospectively evaluated, and 400 children, 264 (66%) girls and 136 (34%) boys, aged 12.6±2.6 years (median 13; range 5–18), with unexplained syncope were enrolled in the study. Age, sex, baseline heart rate, baseline blood pressure, frequency of symptoms, and/or fainting attacks were recorded. The test protocol consisted of 25 minutes of supine resting followed by 20 minutes of 70° upright positioning. Subjects were divided into nine groups according to their differing haemodynamic patterns. Results: There were no statistically significant differences between the groups with regard to age, gender, baseline blood pressure, and frequency of syncope (p>0.05). The response was compatible with orthostatic intolerance in 28 cases (7.0%), postural orthostatic tachycardia syndrome in 24 cases (6.0%), asymptomatic postural orthostatic tachycardia syndrome in 26 cases (6.5%), orthostatic hypotension in seven cases (1.7%), vasovagal syncope in 38 cases (9.5%), and negative in 274 cases (69.2%). Vasovagal syncope response patterns were of type 3 in nine cases (2.2%), type 2A in 10 cases (2.5%), type 2B in two cases (0.5%), and type 1 (mixed) in 17 cases (4.25%). Conclusions: In the 400 paediatric cases with unexplained syncope, nine different haemodynamic response patterns to head-up tilt testing were discerned. Children with orthostatic intolerance syndromes are increasingly referred to hospitals because of difficulty in daily activities. Therefore, there is need for further clinical trials in these patient groups.

Keywords

Unexplained syncopehead-up tilt testorthostatic intolerance syndromes
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 5 , June 2015 , pp. 911 - 917
Copyright
© Cambridge University Press 2014 

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