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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

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