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Fainting attacks in children
Kirti M Naranje1, Arun Bansal, Sunit C Singhi
1Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Fainting in children, or syncope, is common, often caused by vasovagal syncope. Emergency evaluations focus on ruling out serious conditions, with most cases not requiring hospitalization.
Area of Science:
- Pediatric Emergency Medicine
- Cardiology
- Neurology
Background:
- Syncope is a frequent presentation in pediatric emergency departments.
- Vasovagal syncope is the most prevalent cause of fainting in children.
- Accurate diagnosis is crucial to exclude rare, serious underlying pathologies.
Purpose of the Study:
- To outline the emergency room evaluation strategy for pediatric syncope.
- To differentiate between neurally mediated, cardiovascular, and non-cardiovascular causes.
- To emphasize the importance of history and physical examination in diagnosis.
Main Methods:
- Detailed patient history taking.
- Comprehensive physical examination.
- Categorization of syncope into major types.
- Performance of 12-lead ECG and standing tests for all patients.
Main Results:
- Most investigations in pediatric syncope cases yield normal results.
- A 12-lead ECG and standing test are vital diagnostic tools.
- The majority of children diagnosed with syncope do not require hospital admission.
Conclusions:
- Effective evaluation of pediatric syncope relies on thorough history and physical exam.
- 12-lead ECG and standing tests aid in identifying the cause of syncope.
- Appropriate management, often outpatient, is based on the underlying etiology.
Abstract:
Fainting attack or syncope in children is a common occurrence, with vasovagal syncope being the commonest cause for majority of pediatric syncope. The aim of emergency room evaluation is not to miss the rare serious underlying disorder causing syncope. A complete detailed history of the event followed by physical examination helps in categorising syncope into the three major categories-neurally mediated, cardiovascular and non cardiovascular syncope. Investigations will remain normal in majority of the cases. A 12-lead ECG and standing test should be done in all the cases which helps in establishing the cause for syncope. Management varies depending upon the cause and majority of them do not require hospital admission.
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