SYNCOPE IN THE PEDIATRIC PATIENT - 20/09/12

Doi : 10.1016/S0733-8651(05)70336-2

Ronn E. Tanel, MD, Edward P. Walsh, MD

Department of Cardiology, Children's Hospital; and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts

Résumé

Syncope during childhood is common. A variable incidence has been reported, from 1 of 2000 emergency department visits,^{71 Pratt J.L., Fleisher G.R. Syncope in children and adolescents Pediatr Emerg Care 1989 ; 5 : 80 [cross-ref]

Cliquez ici pour aller à la section Références} to 47% of interviewed college students.^{61 Murdoch B.D. Loss of consciousness in healthy South African men S Afr Med J 1980 ; 57 : 771

Cliquez ici pour aller à la section Références} Driscoll and colleagues^{14 Driscoll D.J., Jacobsen S.J., Porter C.J. , et al. Syncope in children and adolescents: A population based study of incidence and outcome Circulation 1996 ; 94 : I-54

Cliquez ici pour aller à la section Références} reported an overall incidence of 125 of 100,000 (0.125%) for pediatric patients seeking medical attention. Girls were seen for evaluation more commonly than boys, with the peak incidence occurring between ages 15 and 19 years. Despite its frequency, syncope generates an extraordinary amount of anxiety among patients, families, teachers, coaches, and physicians.

In children and adolescents, the list of causes is generally similar to that described for adults, although the relative frequency and prognosis for the individual diagnoses are somewhat unique. Fortunately, most syncopal events in young patients are isolated and benign in nature. Driscoll's data^{14 Driscoll D.J., Jacobsen S.J., Porter C.J. , et al. Syncope in children and adolescents: A population based study of incidence and outcome Circulation 1996 ; 94 : I-54

Cliquez ici pour aller à la section Références} revealed an association of sudden death and prior syncopal events that was not different from that of sudden death in the general population. This article describes the causes, diagnosis, and treatment of syncope in infants, children, and adolescents, focusing on the differences that must be identified when caring for the pediatric versus adult patient. Recommendations are presented for an economically efficient diagnostic workup and practical approach to treatment.

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Plan

CAUSE

Cardiac Syncope

Noncardiac Syncope

Neurocardiogenic Syncope

DIAGNOSTIC EVALUATION

CONCLUSION

Address reprint requests to Ronn E. Tanel, MD, Department of Cardiology, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115
RET is currently supported by a research fellowship from the American Heart Association, Massachusetts Affiliate, Inc.