The etiological distribution and clinical features of autonomic neuromediated syncope in children and adolescents:single center 15 years retrospective analysis
10.3760/cma.j.issn.1673-4912.2018.08.010
- VernacularTitle:儿童青少年自主神经介导性晕厥的病因分布及临床特征——单中心15年回顾性分析
- Author:
Juan TIAN
1
,
2
;
Runmei ZOU
;
Ping LIN
;
Fang LI
;
Yi XU
;
Cheng WANG
Author Information
1. 410011 长沙,中南大学湘雅二医院儿童医学中心儿童心血管专科 中南大学儿科学研究所
2. 415200 常德,湖南省临澧县人民医院儿科
- Keywords:
Autonomic neuromediated syncope;
Head-up tilt test;
Etiology;
Children;
Adolescents;
Retrospective analysis
- From:
Chinese Pediatric Emergency Medicine
2018;25(8):597-601
- CountryChina
- Language:Chinese
-
Abstract:
Objective To retrospectively analyze the etiological distribution and clinical features of autonomic neuromediated syncope ( NMS) in children and adolescents in single center for 15 years. Methods There were 3182 cases of children and adolescents[aged from 2 to 18 years,the average age(10. 75 ± 3. 13) years] with unexplained syncope or symptoms of presyncope ( including unexplained dizziness,headache,chest tightness,chest pain,sigh,heart palpitations,etc),who came from children syncope outpatient department or inpatient department in the Second Xiangya Hospital,Central South University from September 2000 to October 2015. Of all 3182 cases,1649 cases were male,1533 cases were female. All subjects underwent detailed history collection,careful physical examination,12-lead electrocardiogram,Holter ECG,chest X-ray,echocardiography, EEG and head CT or MRI,blood biochemical examination (including fasting glucose,myocardial enzymes) and were eliminated organic disease of heart,lung,brain and so on,the cause of syncope was not still clear. The head-up tilt test ( HUTT ) was performed after the patient or / and the guardian written informed consent obtained. Results (1)HUTT positive rate was 47. 05％ (1497/3182). Causes for vasovagal syncope in turn was 42. 99％ ( 1368/3182 ) , postural orthostatic tachycardia syndrome was 2. 55％ ( 81/3182 ) , orthostatic hypertension was 0. 79％ (25/3182),orthostatic hypotension was 0. 06％ (2/3182). (2)The clinical symp-toms in NMS of different etiologies were mainly syncope,dizziness,chest tightness,chest pain,headache,heart pal-pitations. Conclusion The causes of NMS in children are vasovagal syncope and postural orthostatic tachycardia syndrome,and the clinical features are syncope,dizziness,chest tightness,chest pain,headache,heart palpitations.
