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Syncope in childhood: a case control clinical study of the familial tendency to faint
1Department of Pediatrics, Dalhousie University, Izaak Walton Killam Hospital for Children, Halifax, Nova Scotia, Canada.
Insights
This study found a strong inherited tendency for children to faint, with most experiencing vasodepressor or vasovagal syncope having a relative with a fainting history. This genetic predisposition is a key factor in diagnosing childhood fainting episodes.
Area of Science:
- Pediatrics
- Genetics
- Cardiology
Background:
- Vasodepressor or vasovagal syncope is a common cause of fainting in children.
- The role of genetic factors in the predisposition to syncope requires further investigation.
Purpose of the Study:
- To investigate the possibility of an inherited tendency to faint in children.
- To compare the family history of syncope in children with syncope to that of their healthy peers.
Main Methods:
- Studied 30 well children diagnosed with vasodepressor or vasovagal syncope.
- Reviewed family history for syncope in patients and compared it to a control group of best friends.
- Statistical analysis (p < 0.01) was used to determine significance.
Main Results:
- 27 out of 30 children with syncope had a first-degree relative with a history of fainting.
- Only 8 out of 24 control families reported a first-degree relative with syncope.
- 11 out of 30 patients had both a sibling and parent with syncope, compared to 1 out of 24 controls.
Conclusions:
- There is a significant inherited tendency for fainting in children.
- The presence of a family history of syncope is a useful diagnostic indicator.
- The inherited tendency for syncope may be multifactorial, requiring environmental triggers for expression.
Abstract:
We investigated the possibility of an inherited tendency to faint by studying 30 consecutively referred well children with vasodepressor or vasovagal syncope. The family history of each patient was reviewed for syncope and for 24 cases was compared with the family history of the child's best friend. None of the best friends had syncope. 27/30 cases and 8/24 best friends had at least one first degree relative with syncope (p less than 0.01). Of the 8 best friend controls with a parent or sibling with syncope, the mother was affected in 7; 4/7 of these mothers had first degree relative(s) with syncope. In 11/30 patients both a sibling and parent had syncope compared with 1/24 of control families (p less than .01). We conclude that there is an inherited tendency to faint since most children who faint have a first degree relative who faints, a useful fact in differential diagnosis. This inherited tendency may be multifactorial but requires an environmental stimulus for expression.