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[Syncope at pediatric ages: evaluation with head-up tilt]

I Pollini1, S Favilli, L De Simone

  • 1UO di Cardiologia, Azienda Ospedaliera A Meyer, Firenze.

Cardiologia (Rome, Italy)
|August 14, 1998
PubMed
Summary

The head-up tilt test (HUTT) is useful for diagnosing neurocardiogenic syncope in children with recurrent fainting. This study found HUTT identified a lower percentage of positive cases than expected, suggesting its promise in guiding treatment.

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Area of Science:

  • Pediatric Cardiology
  • Autonomic Nervous System Disorders

Background:

  • Syncope is common in children, with neurocardiogenic syncope increasingly recognized.
  • The head-up tilt test (HUTT) aids in diagnosing neurocardiogenic syncope.

Purpose of the Study:

  • To evaluate the clinical utility of HUTT in children with recurrent syncope and normal heart structure.
  • To assess HUTT's role in managing pediatric neurocardiogenic syncope.

Main Methods:

  • 243 children (100 males, 143 females; mean age 11.4 years) with recurrent unexplained syncope underwent HUTT.
  • The test involved a 60-degree tilt for 45 minutes, with positive results defined by syncope, hypotension, or bradycardia.

Main Results:

  • 26 patients (10.7%) tested positive for neurocardiogenic syncope.

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  • Vasodepressive response (61.6%) was most common, followed by cardioinhibitory (19.2%) and mixed (19.2%) responses.
  • Positive rates were higher in females (13.3%) than males (7%), and similar across age groups (<10 vs. >10 years).

    • Conclusions:

    • HUTT is a promising method for identifying pediatric syncope patients who may benefit from pharmacotherapy.
    • Further research is needed to define prognosis and treatment for children with positive HUTT results.
    • Outcomes for children with syncope and negative HUTT require assessment.