Naslov
Syncope in pediatric emergency department
(334 Syncope in pediatric emergency department)

Autori
Benco, Nikolina ; Švigir, Alen ; Topalušić, Iva ; Vulin, Katarina ; Premilovac, Zdenka Pleša

Izvornik
Archives of disease in childhood (0003-9888) 106 (2021); 140-141

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
syncope, child, emergency

Sažetak
The objective of this study was to evaluate the various factors related to the children who presented to the emergency department of Children ´s Hospital Zagreb after experiencing syncope. Information about all visits in ER during 2018 was analyzed from a database. Out of all 14115 visits, the syncope was present in 96 patients (0.6%). Their medical history, clinical characteristics, laboratory and diagnostic tests were analyzed. The patients were mainly girls (68%). The mean age of the patients did not differ between genders (girls 12.84±3.86 and boys 12.71±3.54 ; p= 0.868 ; age range 3-18y). 79.1% arrived with an ambulance, while the rest were referred by their primary pediatrician. 57% of the patients arrived between the 08 a.m. and 4 p.m., 32% between 4 p.m. and 10 p.m., while 10% came during the night. 29% arrived during weekend and 71% during workdays. 82% came during the school-year, thus making it obvious that syncope episodes are more often while school obligations last. 60% experienced syncope for the first, second (19%) and third (11%) time. In 85% of patients the event lasted less than one minute, and 80% had prodromal symptoms. The syncope episodes occurred while standing (48%), abrupt stand-up (19%), seating (14%), walking (14%) and during or immediately after exercising (9%). Psychological stress (24%), hyperventilation (10%), trauma or blood-work (19%) were often present. 28% had previously known headache, migraine, diabetes and rhythm disorders. ECG was conducted in 70% (2% pathological), EEG in 20% (1% pathological) and blood work in 57% (6% pathological). Neuropediatric (13%), cardiologic (12.9%) and psychiatric (6%) examinations were performed (0, 1% and 2% pathological, respectively). 22% were admitted in the hospital for further diagnostics and treatment due to diagnostic dilemma, recurrent syncope or new symptoms. At release, 70.8% were diagnosed with reflex syncope (63.5% vasovagal and 7.3% situational), hyperventilation (7.3%), heat illness (4.1%), pseudo syncope (4.2%), breath holding spells (4.2%), orthostatic syncope (3.1%), convulsions (3.2%), toxin exposure (2.1%) and anaphylaxis (1%). The majority of the children experiencing syncope in pediatric ED were not life endangered by cardiac or other underlying etiology. A potentially life-threatening was an anaphylactic shock, toxin exposed children, heat syncope and exercise associated collapse. Based on a detailed history, clinical exam and specific diagnostic procedures, specialists in ED should recognize specific conditions that require attention.

Izvorni jezik
Engleski

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