Shahram Sadeghvand1, parya Tobeh2, Akbar Molaei3* and Roghyieh Ebrahimi1
1Neurology Division, Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran
2Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran
3Cardiology Division, Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran
*Corresponding Author: Akbar Molaei, Cardiology Division, Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran.
Received: December 08, 2021; Published: May 26, 2022
Background: Various causes can lead to a transient decrease in consciousness, which can be traumatic or non-traumatic. Non-traumatic causes include syncope, seizures, and metabolic disorders. Syncope is a common problem in children. The aim of the present study was cardiac findings in patients with syncope referred to a pediatric clinic.
Methods: This is a cross-sectional study of children who referred to the clinic of Tabriz Children's Hospital with at least one episode of syncope. Patients data including number of syncope events, factors leading to syncope (including prolonged standing, hyperventilation, mental stress, exercise, and prolonged starvation); Any aura before syncope (including confusion, palpitation, decreased vision, nausea, sweating, and paleness); Patient medications and family history (including syncope, sudden death, and cardiovascular disease) were recorded. The patient's clinical examination information including heart rate, systolic and diastolic blood pressure in the supine and sitting position (after standing for 2 minutes) was recorded. Cardiopulmonary findings were recorded. 12-lead electrocardiography was performed for patients and information including heart rhythm, heart rate, P wave voltage, QRS length, heart axis and QTc were recorded. If there is a positive electrocardiographic or clinical result, 2D Doppler echocardiography was performed for patients and the results were recorded.
Findings: In this cross-sectional study, 100 children who referred to the clinic of Tabriz Children's Hospital with at least one episode of syncope were enrolled. The mean age of the children was 8.54 ± 2.70 years ranging from 2.5 to 16 years. The average number of syncope episodes at the time of study was 4 syncope with a range between 1 and 12 syncope. In terms of gender distribution, 44 children (44%) were boys and 56 children (56%) were girls. The family history of syncope was positive in 7 children (7%). The most common cause of syncope in children studied was syncope following exercise (33%). The most common aura was palpitation with a frequency of 29%. In the studied children, abnormal ECG was observed in 11 children (11%). Abnormalities included prolonged QTc in 4 cases, ventricular hypertrophy based on high voltage in 2 cases, atrial enlargement in 2 cases, abnormal axis in 1 case, complete heart block in 1 case, and supraventricular tachycardia in 1 case.
Conclusion: The use of an appropriate history and clinical examination along with ECG is of great value in the diagnosis of syncope with cardiovascular causes in children. It is also best to have echocardiography instead of echocardiography for all patients who are suspected and have an abnormal ECG. It was also observed in this study that the main defaults of cardiac syncope include early syncope with common periods, abnormal ECGs, and higher sitting and standing blood pressure differences.
Keywords: Syncope; Vasovagal Disorder; Children; Mortality; Cardiac Syncope
Citation: Akbar Molaei., et al. “Cardiac Findings in Childhood Syncope". Acta Scientific Paediatrics 5.6 (2022): 14-20.
Copyright: © 2022 Akbar Molaei., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.