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The diagnostic protocol in children and adolescents with syncope: a multi-centre prospective study
Qingyou Zhang1, Junbao Du, Cheng Wang
1Department of Pediatrics, Peking University First Hospital, Beijing, China.
Acta Paediatrica (Oslo, Norway : 1992)
|February 3, 2009
Summary
A new diagnostic protocol for pediatric syncope significantly improved diagnosis rates in children and adolescents. This streamlined approach identified the cause of syncope in over 81% of patients, primarily autonomic-mediated reflex syncope.
Area of Science:
- Pediatric Cardiology
- Neurology
- Diagnostic Medicine
Background:
- The diagnostic pathway for pediatric syncope lacks standardization.
- Establishing a clear diagnosis is crucial for effective management of syncope in children.
Purpose of the Study:
- To develop and implement a diagnostic protocol for pediatric syncope.
- To enhance the diagnostic accuracy of pediatricians managing syncope.
Main Methods:
- A prospective study involving 474 pediatric patients (6-17 years) with syncope.
- Initial evaluation included history, physical exam, standing test, and ECG.
- Further investigations prioritized cardiographic, neurological, or psychiatric assessments, with head-up tilt testing for unexplained cases.
Main Results:
- Definite diagnoses were established in 81.1% of patients after protocol implementation.
- Autonomic-mediated reflex syncope was the most common diagnosis (73.0%).
- Initial evaluation provided a definite or possible diagnosis for 24.8% of patients.
Conclusions:
- A simplified diagnostic protocol effectively increases the diagnostic yield for pediatric syncope.
- This protocol aids in identifying the underlying causes of syncope in children and adolescents.
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