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Syncope and sudden death in the adolescent.

C A Walsh1

  • 1Divisions of Pediatric Cardiology and Critical Care Medicine, Pediatric Dysrythmia Center, Albert Einstein College of Medicine, The Children's Hospital at Montefiore, 111 East 210th Street, Bronx, NY 10467.

Adolescent Medicine (Philadelphia, Pa.)
|February 27, 2001
PubMed
Summary

Syncope, or fainting, is common in adolescents, often benign. However, physicians must identify risk factors for sudden death, necessitating careful evaluation and referral when needed.

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Area of Science:

  • Cardiology
  • Neurology
  • Pediatrics

Background:

  • Syncope, characterized by sudden loss of consciousness and postural tone due to transient cerebral malfunction, is prevalent in adolescents.
  • While often benign and neurocardiogenic (vasovagal) in origin, syncope can rarely indicate a risk of sudden death.
  • Physicians require knowledge to differentiate benign syncope from life-threatening causes.

Purpose of the Study:

  • To outline the evaluation of syncope in adolescents.
  • To identify risk factors associated with syncope that may indicate serious underlying conditions.
  • To guide management strategies for adolescents experiencing syncope.

Main Methods:

  • Comprehensive personal and family history collection.
  • Thorough physical examination.
  • Electrocardiogram (ECG) as a primary diagnostic tool.

Main Results:

  • Key risk factors for severe syncope include recurrent episodes, exercise induction, non-neurocardiogenic etiology, anginal chest pain, palpitations, dyspnea, cardiac disease, seizure activity, and a family history of sudden death syndromes.
  • Adolescents presenting with these risk factors warrant specialized cardiological assessment.
  • Early identification and management are crucial for preventing adverse outcomes.

Conclusions:

  • Syncope evaluation in adolescents requires a detailed history, physical exam, and ECG.
  • Recognizing specific risk factors is critical for distinguishing benign cases from those with potentially fatal etiologies.
  • Referral to pediatric cardiology is essential for adolescents with concerning syncope risk factors.

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