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SYNCOPA IN CHILDREN AND ADOLESCENTS OUR EXPERIENCE
Medicinski fakultet, University of Priština - Kosovska Mitrovica, Mitrovica, Kosovo
Medicinski fakultet, University of Priština - Kosovska Mitrovica, Mitrovica, Kosovo
KBC Zemun, Belgrade,
Medicinski fakultet, University of Priština - Kosovska Mitrovica, Mitrovica, Kosovo
KBC Priština, Gračanica,
Abstract
Introduction: Syncope is a sudden, short-lived, transient loss of consciousness associated with the inability to maintain postural tone. The aim of this paper is: to determine the frequency of syncope in children and adolescents in our conditions, to analyze the characteristics of syncopal episodes and clinical presentation in order to identify the etiology of seizures, and to provide diagnostic protocols, i.e. guidelines for streamlining clinical trials.
Methodology: The diagnosis of the disease was made clinically on the basis of well-taken anamnestic data and a detailed description of the quality of the attack, physical examination and routine laboratory analyzes: (CBC, glycemia, standard ECG). Additional tests were selectively performed: Holter ECG, ergometry, Tilt table test, Echocardiogram, NMR, EEG.
Results: Out of the total number of examined children in the outpatient Children’s Hospital, Department of Pediatric Cardiology, 139 patients (0.6%) reported due to short-term loss of consciousness. The largest number of children was between 15 and 18 years old. Ninety-two ( 66%) of those 139 were girls, and 47 (34%) were boys (p <0.05). Regarding the cause of syncope, it was found in 117 (84%) patients, and in 22 (16%) children the cause of syncope was unknown (p <0.05). Etiologically spreaking, syncope was divided into 3 groups: autonomic (vasovagal, situational, orthostatic, increased vagus tone in athletes) was the most common, in 88 patients (75%), cardiogenic in 5 (4%) and non-cardiogenic in 24 patients.(21%). There was also a recurrence of the attack. In two children, the syncopal attack was repeated 4 times.
CONCLUSION: Syncope most often occurs in teenagers and is mostly benign. To assess syncope, it is necessary to gather a detailed history of the attack, to conduct a detailed physical examination and routine laboratory analyzes: CBC, glycemia and standard ECG. Supplementary diagnostics should be performed exclusively in patients where there is a reasonable suspicion of heart disease or neurological diseases.
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