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Syncope in Childhood: A Case Control Clinical Study of the Familial Tendency to Faint

Published online by Cambridge University Press:  18 September 2015

Peter R. Camfield*
Affiliation:
Department of Pediatrics, Dalhousie University, Izaak Walton Killam Hospital for Children, Halifax, Nova Scotia
Carol S. Camfield
Affiliation:
Department of Pediatrics, Dalhousie University, Izaak Walton Killam Hospital for Children, Halifax, Nova Scotia
*
Izaak Walton Killam Hospital for Children, Box 3070, Halifax, Nova Scotia, Canada B3J 3G9
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Abstract:

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We investigated the possibility of an inherited tendency to faint by studying 30 consecutively referred well children with vasodepressor or vasovagal syncope. The family history of each patient was reviewed for syncope and for 24 cases was compared with the family history of the child's best friend. None of the best friends had syncope. 27/30 cases and 8/24 best friends had at least one first degree relative with syncope (p < 0.01). Of the 8 best friend controls with a parent or sibling with syncope, the mother was affected in 7; 4/7 of these mothers had first degree relative(s) with syncope. In 11/30 patients both a sibling and parent had syncope compared with 1/24 of control families (p < .01). We conclude that there is an inherited tendency to faint since most children who faint have a first degree relative who faints, a useful fact in differential diagnosis. This inherited tendency may be multifactorial but requires an environmental stimulus for expression.

Résumé:

RÉSUMÉ:

Nous avons investigué la possibilité qu'il existe une tendance héréditaire à la syncope en étudiant 30 cas consécutifs d'enfants en bonne santé référés pour syncope vasovaguale ou par collapsus circulatoire. L'histoire familiale de chaque patient a été révisée en ce qui concerne la syncope. Pour 24 des cas, cette histoire familiale a été comparée à celle du meilleur ami de l'enfant. Aucun des contrôles n'avait de syncope. Vingt-sept cas sur 30 et 8 contrôles sur 24 avait au moins un parent au premier degré qui présentait des syncopes (p < 0.01). Des 8 contrôles qui avaient un parent ou un membre de la fratrie avec syncopes, chez 7 la mère était le parent atteint; 4 parmi ces 7 mères avaient un parent au premier degré qui avait des syncopes. Chez 11 des 30 patients, un membre de la fratrie et un parent présentaient également des syncopes, comparé à 1 sur 24 chez les families contrôles (p < 0.01). Nous concluons qu'il existe une tendance héréditaire à la lipothymie parce que la plupart des enfants qui ont des syncopes ont un parent au premier degré qui a également des syncopes, un fait utile au diagnostic différentiel. Cette tendance héréditaire peut être multifactorielle, mais requière un stimulus environnemental pour son expression.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1990

References

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