[Syncope in children and young adults].

Area of Science:

• Pediatric Cardiology
• Neurology
• Internal Medicine

Context:

• Syncope affects 15-40% of pediatric and young adult populations.
• Reflex-mediated syncope accounts for the majority (60-70%) of cases.
• Cardiac syncope, though less common (5-6%), encompasses critical, life-threatening conditions.

Purpose:

• To outline the causes, diagnostic approaches, and management strategies for syncope in children and young adults.
• To differentiate between benign reflex-mediated syncope and potentially fatal cardiac syncope.
• To emphasize the importance of diagnosing and treating cardiac syncope.

Summary:

• A comprehensive medical history, ECG, and echocardiography are vital for detecting cardiac syncope.
• Reflex-mediated syncope typically presents with a characteristic history and normal physical/ECG findings; a tilt test may be indicated.
• Cardiac syncope may manifest during exercise or suddenly, requiring tailored treatment based on the underlying condition, including medication and device therapy.

Impact:

• Accurate diagnosis ensures appropriate management, distinguishing benign conditions from serious cardiac etiologies.
• Early identification of cardiac syncope can prevent severe complications and improve patient outcomes.
• This review provides essential guidance for clinicians managing syncope in pediatric and young adult patients.