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Related Experiment Videos

Syncope in children and adolescents.

J L Pratt1, G R Fleisher

  • 1Department of Pediatric Emergency Medicine, Miami Children's Hospital, FL 33155.

Pediatric Emergency Care
|June 1, 1989
PubMed
Summary

Fainting in children and adolescents is often diagnosed as vasovagal syncope or orthostatic hypotension. Initial emergency department evaluations for fainting should include vital signs, glucose, hematocrit, and ECG.

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Area of Science:

  • Pediatrics
  • Emergency Medicine
  • Neurology

Background:

  • Fainting (syncope) is a common reason for emergency department visits in children and adolescents.
  • Accurate diagnosis is crucial for appropriate management and to rule out serious underlying conditions.

Purpose of the Study:

  • To analyze the causes of syncope and near-syncope in pediatric patients presenting to the emergency department.
  • To identify key diagnostic evaluations for first-episode syncope in this population.

Main Methods:

  • Retrospective review of emergency department records for 77 children and adolescents with chief complaint of fainting.
  • Categorization of patients into syncope, near-syncope, or no episode based on clinical review.
  • Analysis of diagnostic outcomes and initial evaluation findings.

Main Results:

  • Of 57 patients with syncopal or near-syncopal episodes, 40 had syncope and 17 had near-syncope.
  • Common diagnoses for syncope included vasovagal syncope (50%) and orthostatic hypotension (20%).
  • Common diagnoses for near-syncope included lightheadedness (29%) and seizure (18%).
  • Abnormalities in vital signs, orthostatic vital signs, glucose, hematocrit, or ECG were found in 17.5% of syncopal patients, but none of the near-syncopal patients.

Conclusions:

  • Vasovagal syncope and orthostatic hypotension are frequent causes of syncope in pediatric emergency department visits.
  • Initial evaluation for first-episode syncope in children should incorporate orthostatic vital signs, glucose, hematocrit, and ECG.
  • Further investigations should be guided by clinical findings and initial test results.

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