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Value of history taking in children and adolescents with cardiac syncope

Published online by Cambridge University Press:  15 March 2012

Qingyou Zhang ,
Lulu Zhu ,
Cheng Wang ,
Zhongdong Du ,
Xiufen Hu ,
Hong Tian ,
Ochs Todd ,
Fengwen Zhang ,
Junbao Du  and
Hongfang Jin
Qingyou Zhang
Affiliation:
Department of Pediatrics, Peking University First Hospital, Beijing, China
Lulu Zhu
Affiliation:
Department of Pediatrics, Peking University First Hospital, Beijing, China
Cheng Wang
Affiliation:
Department of Pediatrics, Xiangya Second Hospital of Zhongnan University, Changsha, China
Zhongdong Du
Affiliation:
Department of Cardiology, Beijing Children's Hospital, Capital Medical University, Beijing, China
Xiufen Hu
Affiliation:
Department of Pediatrics, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
Hong Tian
Affiliation:
Department of Pediatrics, Children's Hospital of Fudan University, Shanghai, China
Ochs Todd
Affiliation:
Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
Fengwen Zhang
Affiliation:
Department of Pediatrics, Peking University First Hospital, Beijing, China
Junbao Du*
Affiliation:
Department of Pediatrics, Peking University First Hospital, Beijing, China Key Laboratory of Molecular Cardiology, Ministry of Education, Beijing, China
Hongfang Jin*
Affiliation:
Department of Pediatrics, Peking University First Hospital, Beijing, China
*
Correspondence to: Professors J. Du and H. Jin, Department of Pediatrics, Peking University First Hospital, Xi-An Men Street no. 1, West District, Beijing 100034, China. Tel: +8610 83573238; Fax: +8610 66530532; E-mail: junbaodu1@126.com; jinhongfang51@126.com
Correspondence to: Professors J. Du and H. Jin, Department of Pediatrics, Peking University First Hospital, Xi-An Men Street no. 1, West District, Beijing 100034, China. Tel: +8610 83573238; Fax: +8610 66530532; E-mail: junbaodu1@126.com; jinhongfang51@126.com
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Abstract

Aim

This study was designed to investigate the value of history taking in identifying children with cardiac syncope, and to improve diagnostic efficiency and accuracy in children with cardiac syncope.

Methods and Results

We compared the characteristics of a group of children and adolescents with cardiac syncope at the Pediatric Syncope Unit of five hospitals in China with those with typical vasovagal syncope. We included a cohort of 275 patients in Pediatric Syncope Unit. A cardiac cause of syncope was established in 31 patients, autonomic-mediated reflex syncope in 214, non-syncopal attacks in 15, and in the remaining 15 the cause of syncope remained unexplained. Cardiac syncope was triggered by exercise, whereas vasovagal syncope by prolonged standing, warm-crowded place, and fear or pain emotion. Syncopal spells occurred at various positions in cardiac syncope. Children who had prodromal symptoms with cardiac syncope were significantly fewer than those with vasovagal syncope. Most children with cardiac syncope had history of abnormal electrocardiogram findings when compared with children suffering from vasovagal syncope. On multivariable analysis, history of abnormal electrocardiogram findings and exercise-triggered syncope were independent predictors of cardiac syncope.

Conclusion

Children and adolescents with a history of abnormal electrocardiogram findings and exercise-related syncope spells were at high risk for cardiac syncope.

Keywords

Syncopepaediatricsheart disease
Type
Original Article
Information
Cardiology in the Young , Volume 23 , Issue 1 , February 2013 , pp. 54 - 60
Copyright
Copyright © Cambridge University Press 2012

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Footnotes

*

They contributed equally to this work

References

1. Driscoll, DJ, Jacobsen, SJ, Porter, CJ, Wollan, PC. Syncope in children and adolescents. J Am Coll Cardiol 1997; 29: 1039–1045.CrossRefGoogle ScholarPubMed
2. Massin, M, Bourguignont, A, Coremans, C, Comté, L, Lepage, P, Gérard, P. Syncope in pediatric patients presenting to an emergency room. J Pediatr 2004; 145: 223–228.CrossRefGoogle Scholar
3. Wieling, W, Ganzeboom, KS, Saul, JP. Reflex syncope in children and adolescents. Heart 2004; 90: 1094–1100.CrossRefGoogle ScholarPubMed
4. Wong, KT, So, LY. Syncope in children and adolescents of Hong Kong. J Paediatr Child Health 2002; 38: 196–198.CrossRefGoogle ScholarPubMed
5. Zhang, Q, Junbao, D, Jiong, Q, Yonghong, C, Wanzhen, L, Xinhua, B. Etiologic and clinical characteristics of syncope in children. Zhonghua Er Ke Za Zhi 2007; 45: 59–63.Google ScholarPubMed
6. Zhang, Q, Du, J, Wang, C, Du, Z, Wang, L, Tang, C. The diagnostic protocol in children and adolescents with syncope: a muti-centre prospective study. Acta Peadiatr 2009; 98: 879–884.CrossRefGoogle ScholarPubMed
7. Wren, C. Cardiac causes for syncope or sudden death in childhood. Arch Dis Child 1999; 81: 289–291.CrossRefGoogle ScholarPubMed
8. European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), Heart Rhythm Society (HRS), European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), European Federation of Autonomic Societies (EFAS), American Autonomic Society (AAS). Guidelines for the diagnosis and management of syncope (version 2009): the Task Force for the Diagnosis and Management of Syncope of the European Society of Cardiology (ESC), Eur Heart J, 2009; 30: 2631–2671.CrossRefGoogle Scholar
9. Sarasin, FP, Hanusa, BH, Perneger, T, Louis-Simonet, M, Rajeswaran, A, Kapoor, WN. A risk score to predict arrhythmias in patients with unexplained syncope. Acad Emerg Med 2003; 10: 1312–1317.CrossRefGoogle ScholarPubMed
10. Rosso, AD, Ungar, A, Maggi, R, et al. Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to a general hospital: the EGSYS score. Heart 2008; 94: 1620–1626.CrossRefGoogle ScholarPubMed
11. Qingyou, Z, Junbao, D, Jianjun, C, Wanzhen, L. Association of clinical characteristics of children with unexplained syncope and the outcome of head-up tilt tests. Pediatr Cardiol 2004; 25: 360–364.CrossRefGoogle ScholarPubMed
12. Alboni, P, Brignole, M, Menozzi, C, et al. Diagnostic value of history in patients with syncope with or without heart disease. J Am Coll Cardiol 2001; 37: 1921–1928.CrossRefGoogle ScholarPubMed
13. Calkins, H, Shyr, Y, Frumin, H, Schork, A, Morady, F. The value of the clinical history in differentiation of syncope due to ventricular tachycardia, atrioventricular block, and neurocardiogenic syncope. Am J Med 1995; 98: 365–373.CrossRefGoogle ScholarPubMed
14. Sheldon, R, Rose, S, Connolly, SJ, Ritchie, D, Koshman, ML, Frenneaux, M. Diagnostic criteria for vasovagal syncope based on a quantitative history. Eur Heart J 2006; 27: 344–350.CrossRefGoogle ScholarPubMed
15. Soteroades, ES, Evans, JC, Larson, MG, et al. Incidence and prognosis of syncope. N Engl J Med 2002; 347: 878–885.CrossRefGoogle Scholar
16. Massin, MM, Malekzadeh-Milani, S, Benatar, A. Cardiac syncope in pediatric patients. Clin Cardiol 2007; 30: 81–85.CrossRefGoogle ScholarPubMed
17. Colman, N, Bakker, A, Linzer, M, Reitsma, JB, Wieling, W, Wilde, AAM. Value of history-taking in syncope patients: in whom to suspect long QT syndrome. Europace 2009; 11: 937–943.CrossRefGoogle ScholarPubMed
18. Qingyou, Z, Junbao, D, Chaoshu, T. The efficacy of midodrine hydrochloride in the treatment of children with vasovagal syncope. J Pediatr 2006; 149: 777–780.CrossRefGoogle ScholarPubMed
19. Strickberger, SA, Benson, DW, Biaggioni, I, et al. American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke; Quality of Care and Outcomes Research Interdisciplinary Working Group; American College of Cardiology Foundation; Heart Rhythm Society; American Autonomic Society. AHA/ACCF Scientific Statement on the evaluation of syncope. Circulation 2006; 113: 316–327.CrossRefGoogle Scholar
20. Costantino, G, Perega, F, Dipaola, F, et al. Short and long-term prognosis of syncope, risk factors, and role of hospital admission. J Am Coll Cardiol 2008; 51: 276–283.CrossRefGoogle Scholar