A retrospective analysis of the cost-effective workup of syncope in children

Ta, Gordon; Ds, Moodie; Passalacqua, Matthew; Sterba, Richard; Ad, Rothner; Erenberg, Gerald; Rp, Cruse

doi:10.3949/ccjm.54.5.391

Cited by 33 publications

(17 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consequently, an evaluation that fails to approach this problem in a goal directed fashion will prove to be very expensive, time-consuming, and frustrating to all concerned. 4 Detailed family history, personal history, and physical examination are important, but, above all, the history of the event is critical for developing the differential diagnosis, workup, and management plan. 1 -6 Attention should be paid to activities leading up to the event, the patient's position when he became symptomatic, associated symptoms, and duration of the episode.…”

Section: Discussionmentioning

confidence: 99%

“…Retrospective assessment of the history of victims of sudden death sometimes suggests that earlier recognition of the problem might have led to a different outcome. 4 This study was conducted to determine the etiology of cardiac syncope in a cohort of children to analyze the elements that suggest the cardiac origin of syncope and evaluate the efficiency of guidelines on the diagnosis of cardiac syncope.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cardiac Syncope in Pediatric Patients

Massin

Malekzadeh‐Milani

Benatar

2007

Clinical Cardiology

View full text Add to dashboard Cite

SummaryObjective: To assess the epidemiology of cardiac syncope in children and evaluate the guidelines on its management.Material and methods: We analyzed the etiology to syncope and diagnostic workup in consecutive pediatric patients presenting with syncope in our emergency departments or cardiac outpatient clinics between 1997 and 2005, and who were subsequently diagnosed as having cardiac syncope.Results: A primary cardiac cause was identified in 11 syncopal patients presenting to the emergency room and 14 patients to the cardiac clinic: supraventricular tachyarrhythmia in 9, ventricular tachyarrhythmia in 10, pacemaker dysfunction in 2, and isolated cases of sick sinus syndrome, hypoxic spell, hypertrophic cardiomyopathy, and primary pulmonary hypertension. Some elements suggested potential cardiac disease as a cause of syncope in all cases. The resting electrocardiogram and the echocardiogram were interpreted as positive and relevant to the diagnosis in 17 and 3 patients, respectively. Exercise electrocardiogram and Holter recording provided diagnostic information previously not seen on the resting electrocardiogram in six and three patients,

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cardiac Syncope in Pediatric Patients

Massin

Malekzadeh‐Milani

Benatar

2007

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…10,28,29 More recent surveys, however, mention an underlying psychological disorder in nearly one-third of unselected young patients who presented for an evaluation of syncope. 1,30,31 Unfortunately, tilt tests were not done in these studies and the diagnosis of hyperventilation syncope was based on the much-criticized voluntary hyperventilation test. 10 Neurallymediated syncope was not distinguished from psychogenic syncope.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] A detailed history and the CHUTT were the most important instruments in establishing the cause of syncope.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, certain pathological entities, including some potentially dangerous ones, can present with syncope; therefore, it is important to consider which patients require further investigation. [1][2][3][4][5][6] The development of the head-up tilt test (HUTT) especially in adult medicine has contributed to our understanding of this condition. 7 When a normal person stands, 10% to 15% of the blood is pooled in the legs reducing cardiac output and arterial pressure.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The Role of the Capnography Head-up Tilt Test in the Diagnosis of Syncope in Children and Adolescents

Naschitz¹,

Hardoff

Bystritzki³

et al. 1998

Pediatrics

View full text Add to dashboard Cite

ABSTRACT. Objectives. To evaluate the role of the capnography head-up tilt test (CHUTT) in the diagnosis of syncope in pediatric patients.Methods. The CHUTT is a head-up tilt test with concomitant capnometry. Hyperventilation on CHUTT was diagnosed when the patient's end-tidal carbon dioxide pressure (ETPCO 2 ) was <25 mm Hg. Hyperventilation syncope was diagnosed when three criteria were met: loss of consciousness, ETPCO 2 <25 mm Hg, and no significant drop in blood pressure. The cohort included 65 consecutive children and adolescents (mean age, 14.2 years) who were assessed for syncope by routine investigations and CHUTT.Results. The cause of the syncope was established in 67% of cases: cardioinhibitory reaction in 17%, vasodepressor in 20%, psychogenic in 22%, and mixed neurally mediated-psychogenic in 8% of the patients. The history indicated a cause of syncope in 40%, the CHUTT in 49%, and a combination of the history and positive CHUTT in 66% of patients. Neither the patients' clinical data nor values of the blood pressure, heart rate, respiratory rate, and ETPCO 2 measured during recumbency predicted which patients would manifest hyperventilation or hyperventilation syncope on tilt.Conclusions. The CHUTT contributes substantially to the diagnosis of syncope in pediatric patients. The CHUTT advances the understanding of the pathophysiological mechanisms of syncope and enables the physician to reassure the patient regarding the essentially benign nature of the condition. Because it is not possible to predict which patients would develop a hyperventilation syncope on the standard tilt test, the modification of this procedure by measuring the ETPCO 2 for the assessment of children with syncope should be considered. Pediatrics 1998;101(2). URL: http://www.pediatrics.org/ cgi/content/full/101/2/e6; syncope, pediatric, tilt test, capnography.

show abstract

Movement Disorders and Paroxysmal Behaviors in Children and Adolescents

Golden

1991

Developmental-Behavioral Disorders

View full text Add to dashboard Cite

A retrospective analysis of the cost-effective workup of syncope in children

Cited by 33 publications

References 4 publications

Cardiac Syncope in Pediatric Patients

Cardiac Syncope in Pediatric Patients

The Role of the Capnography Head-up Tilt Test in the Diagnosis of Syncope in Children and Adolescents

Movement Disorders and Paroxysmal Behaviors in Children and Adolescents

Contact Info

Product

Resources

About