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Tilt table testing to diagnose pseudosyncope in the pediatric population.

Jeffrey A Robinson1, Jill K Shivapour1, Christopher S Snyder1

  • 1The Congenital Heart Collaborative, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.

Congenital Heart Disease
|February 28, 2017
PubMed
Summary

The head-up tilt table test effectively diagnoses pseudosyncope in pediatric patients. Inductive techniques and disruptive maneuvers aid in confirming this condition, leading to appropriate treatment.

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Area of Science:

  • Pediatric Neurology
  • Cardiology
  • Autonomic Dysfunction

Background:

  • Pseudosyncope is challenging to differentiate from true syncope in children.
  • Pediatric patients often face delayed diagnoses and numerous tests for pseudosyncope.

Purpose of the Study:

  • To evaluate the utility of the head-up tilt table test in diagnosing pseudosyncope in pediatric patients.
  • To describe the effectiveness of specific techniques during tilt table testing for pseudosyncope identification.

Main Methods:

  • Retrospective review of 89 pediatric patients (age ≤23 years) undergoing head-up tilt table testing.
  • Assessment of pretest probability for pseudosyncope based on clinical factors.
  • Utilization of inductive techniques to elicit episodes and disruptive maneuvers to confirm diagnosis.
Keywords:
pediatricpseudosyncopesyncopetilt table testing

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Main Results:

  • The head-up tilt table test identified pseudosyncope in 8 out of 36 patients who experienced syncope during testing.
  • Inductive techniques were crucial for diagnosing late-onset pseudosyncope episodes.
  • Normal vital signs during events and positive responses to disruptive maneuvers confirmed pseudosyncope.

Conclusions:

  • Head-up tilt table testing is a valuable tool for diagnosing pseudosyncope in pediatric populations.
  • Employing inductive techniques and disruptive maneuvers enhances diagnostic accuracy.
  • Timely diagnosis via tilt table testing facilitates appropriate management and treatment for pediatric pseudosyncope.