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Clinical analysis and follow-up results of children with vasovagal syncope

Year 2013, Volume: 40 Issue: 3, 369 - 373, 01.09.2013
https://doi.org/10.5798/diclemedj.0921.2013.03.0291

Abstract

Objective: Syncope is a common clinical problem that occurs at all ages and is particularly prevalent in childhood and adolescence. In this study we aimed to investigate the continuity of the symptoms and effectiveness of the therapy in patients who received medical therapy. In addition, we investigated the association of tilt positivity or negativity with the continual syncope complaints by repeating head-up tilt test (HUTT). Methods: Forty-nine patients with vasovagal syncope followed-up for 6 or more months were contacted with telephone call. Follow-up period, syncope and presyncopal attack frequency and status of drug usage of the patients were recorded. The HUTT was repeated in all patients. Data were evaluated by statistical methods. Results: There were 27 female (55%) and 22 male (45%) patients with a mean age of 14.9±7.9. The mean follow-up period was 15.6±8.9 months. No significant sexual differences were determined for the negativity and the positivity of the test (p>0.05). Tilt test positivity rate was significantly lower than the first tilt test (p

References

  • Aydin MA, Salukhe TV, Wilke I, Willems S. Management and therapy of vasovagal syncope: A review. World J Car- diol 2010;26:308-315.
  • Parry SW, Kenny RA. The management of vasovagal syn- cope. QJM 1999;92:697-705.
  • Kapoor WN. Evaluation and outcome of patients with syn- cope. Medicine (Baltimore) 1990;69:160-175.
  • Wieling W, Ganzeboom KS, Saul JP. Reflex syncope in chil- dren and adolescents. Heart 2004;90:1094-1100.
  • Sheldon R, Rose S, Flanagan P, et al. Risk factors for synco- pe recurrence after a positive tilt-table test in patients with syncope. Circulation 1996;93:973-981.
  • Brignole M, Alboni P, Benditt D, et al. Guidelines on man- agement (diagnosis and treatment) of syncope. Eur Heart J 2001;22:1256-1306.
  • Grubb BP, Temesy-Armos P, Moore J, et al. The use of head- upright tilt table testing in children and adolescents. Pacing Clin Electrophysiol 1992;15:742-748.
  • Savage DD, Corwin L, McGee DL, et al. Epidemiologic fea- tures of isolated syncope: the Framingham Study. Stroke 1985;16:626-629.
  • Lewis DA, Zlotocha J, Henke L, Dhala A. Specificity of head-up tilt testing in adolescents, effects of various de- grees of tilt challenge in normal control subjects. J Am Coll Cardiol 1997;30:1057-1060.
  • Ross BA, Hughes S, Andersen E, Gillette PC. Abnormal responses to orthostatic testing in children and adolescents with recurrent unexpplained syncope. Am Heart J 1991; 122:748-754.
  • Kapoor WN, Brant N. Evaluation of syncope by upright tilt testing with isoproterenol. A nonspecific test. Ann Intern Med 1992;116:358-363.
  • Alehan D, Lenk M, Ozme S, et al. Comparison of sensitiv- ity and specificity of tilt protocols with and without isopro- terenol in children with unexplained syncope. Pacing Clin Electrophysiol 1997;20:1769-1776.
  • Benditt DG, Ferguson DW, Grubb BP, et al. Tilt table test- ing for assessing syncope. American College of Cardiology. J Am Coll Cardiol 1996;28:263-275.
  • Macedo PG, Leite LR, Santos-Neto L, Hachul D. Tilt test- -from the necessary to the indispensable. Arq Bras Cardiol 2011;96:246-254.
  • de Buitleir M, Grogan EW Jr, Picone MF, Casteen JA. Im- mediate reproducibility of the tilt table test in adults with unexplained syncope. Am J Cardiol 1993;71:304-307.
  • Brooks R, Ruskin JN, Powell AC, et al. Prospective evalu- ation of day-to-day reproducibility of upright tilt-table test- ing in unexplained syncope. Am J Cardiol 1993;71:1289- 1292.
  • Alehan D, Uner A, Ayabakan C, et al. Reproducibility of head-up tilt test results in children with vasovagal syncope. Int J Cardiol 2003;88:19-25.
  • Pavri BB, Ruskin JN, Brooks R. The yield of head-up tilt testing is not significantly increased by repeating the base- line test. Clin Cardiol 1996;19:494-496.
  • Kouakam C, Vaksmann G, Pachy E, et al S. Long-term fol- low-up of children and adolescents with syncope. Predictor of syncope recurrence. Eur Heart J 2001;22:1618-1625.
  • Diaz JF, Tercedor L, Moreno E, et al. Vasovagal syncope in pediatric patients: a medium-term follow-up analysis. Rev Esp Cardiol 2002;55:487-492.
  • Biffi M, Boriani G, Bronzetti G, et al. Neurocardiogenic syncope in selected pediatric patients-natural history during long-term follow-up and effect of prophylactic pharmaco- logical therapy. Cardiovasc Drugs Ther 2001;15:161-167.

Vazovagal senkoplu çocuklarda klinik değerlendirme ve takip sonuçları

Year 2013, Volume: 40 Issue: 3, 369 - 373, 01.09.2013
https://doi.org/10.5798/diclemedj.0921.2013.03.0291

Abstract

Amaç: Senkop özellikle çocukluk ve adolesan yaş grubunda daha sık olmakla birlikte her yaş grubunda görülebilen klinik bir problemdir. Bu çalışmada, vazovagal senkoplu hastalarda semptomların devamı ve medikal tedavi verilen hastalarda tedavinin etkinliği araştırıldı. Ayrıca tilt testi sonuçlarının pozitif ve negatif olması ile devam eden senkop şikâyetleri arasındaki ilişki incelendi. Metod: Vazovagal senkop tanısıyla 6 ay veya daha uzun süredir takip edilen 49 hasta telefon ile irtibat kurularak hastanemize çağrıldı. Hastaların takip süreleri, senkop ve presenkop sıklığı, ilaç kullanım öyküleri kaydedildi ve tüm hastalara tekrar tilt testi uygulandı. Elde edilen bulgular istatistiksel olarak değerlendirildi. Bulgular: Hastaların 27\'si kız (%55), 22\'si erkek (%45), ortalama yaş 14,9±7,9 yıl, ortalama takip süresi 15,6±8,9 aydır. Kız ve erkekler arasında tilt testi sonucunun pozitif veya negatif olması açısından anlamlı bir fark yoktu (p>0,05). İkinci tilt testinde pozitiflik oranı ilk teste göre anlamlı olarak düşük bulunmuştur (p

References

  • Aydin MA, Salukhe TV, Wilke I, Willems S. Management and therapy of vasovagal syncope: A review. World J Car- diol 2010;26:308-315.
  • Parry SW, Kenny RA. The management of vasovagal syn- cope. QJM 1999;92:697-705.
  • Kapoor WN. Evaluation and outcome of patients with syn- cope. Medicine (Baltimore) 1990;69:160-175.
  • Wieling W, Ganzeboom KS, Saul JP. Reflex syncope in chil- dren and adolescents. Heart 2004;90:1094-1100.
  • Sheldon R, Rose S, Flanagan P, et al. Risk factors for synco- pe recurrence after a positive tilt-table test in patients with syncope. Circulation 1996;93:973-981.
  • Brignole M, Alboni P, Benditt D, et al. Guidelines on man- agement (diagnosis and treatment) of syncope. Eur Heart J 2001;22:1256-1306.
  • Grubb BP, Temesy-Armos P, Moore J, et al. The use of head- upright tilt table testing in children and adolescents. Pacing Clin Electrophysiol 1992;15:742-748.
  • Savage DD, Corwin L, McGee DL, et al. Epidemiologic fea- tures of isolated syncope: the Framingham Study. Stroke 1985;16:626-629.
  • Lewis DA, Zlotocha J, Henke L, Dhala A. Specificity of head-up tilt testing in adolescents, effects of various de- grees of tilt challenge in normal control subjects. J Am Coll Cardiol 1997;30:1057-1060.
  • Ross BA, Hughes S, Andersen E, Gillette PC. Abnormal responses to orthostatic testing in children and adolescents with recurrent unexpplained syncope. Am Heart J 1991; 122:748-754.
  • Kapoor WN, Brant N. Evaluation of syncope by upright tilt testing with isoproterenol. A nonspecific test. Ann Intern Med 1992;116:358-363.
  • Alehan D, Lenk M, Ozme S, et al. Comparison of sensitiv- ity and specificity of tilt protocols with and without isopro- terenol in children with unexplained syncope. Pacing Clin Electrophysiol 1997;20:1769-1776.
  • Benditt DG, Ferguson DW, Grubb BP, et al. Tilt table test- ing for assessing syncope. American College of Cardiology. J Am Coll Cardiol 1996;28:263-275.
  • Macedo PG, Leite LR, Santos-Neto L, Hachul D. Tilt test- -from the necessary to the indispensable. Arq Bras Cardiol 2011;96:246-254.
  • de Buitleir M, Grogan EW Jr, Picone MF, Casteen JA. Im- mediate reproducibility of the tilt table test in adults with unexplained syncope. Am J Cardiol 1993;71:304-307.
  • Brooks R, Ruskin JN, Powell AC, et al. Prospective evalu- ation of day-to-day reproducibility of upright tilt-table test- ing in unexplained syncope. Am J Cardiol 1993;71:1289- 1292.
  • Alehan D, Uner A, Ayabakan C, et al. Reproducibility of head-up tilt test results in children with vasovagal syncope. Int J Cardiol 2003;88:19-25.
  • Pavri BB, Ruskin JN, Brooks R. The yield of head-up tilt testing is not significantly increased by repeating the base- line test. Clin Cardiol 1996;19:494-496.
  • Kouakam C, Vaksmann G, Pachy E, et al S. Long-term fol- low-up of children and adolescents with syncope. Predictor of syncope recurrence. Eur Heart J 2001;22:1618-1625.
  • Diaz JF, Tercedor L, Moreno E, et al. Vasovagal syncope in pediatric patients: a medium-term follow-up analysis. Rev Esp Cardiol 2002;55:487-492.
  • Biffi M, Boriani G, Bronzetti G, et al. Neurocardiogenic syncope in selected pediatric patients-natural history during long-term follow-up and effect of prophylactic pharmaco- logical therapy. Cardiovasc Drugs Ther 2001;15:161-167.
There are 21 citations in total.

Details

Primary Language Turkish
Journal Section Research Articles
Authors

Ahmet Midhat Elmacı This is me

Fatih Akın This is me

Sevim Karaarslan This is me

Publication Date September 1, 2013
Submission Date March 2, 2015
Published in Issue Year 2013 Volume: 40 Issue: 3

Cite

APA Elmacı, A. M., Akın, F., & Karaarslan, S. (2013). Vazovagal senkoplu çocuklarda klinik değerlendirme ve takip sonuçları. Dicle Medical Journal, 40(3), 369-373. https://doi.org/10.5798/diclemedj.0921.2013.03.0291
AMA Elmacı AM, Akın F, Karaarslan S. Vazovagal senkoplu çocuklarda klinik değerlendirme ve takip sonuçları. diclemedj. September 2013;40(3):369-373. doi:10.5798/diclemedj.0921.2013.03.0291
Chicago Elmacı, Ahmet Midhat, Fatih Akın, and Sevim Karaarslan. “Vazovagal Senkoplu çocuklarda Klinik değerlendirme Ve Takip sonuçları”. Dicle Medical Journal 40, no. 3 (September 2013): 369-73. https://doi.org/10.5798/diclemedj.0921.2013.03.0291.
EndNote Elmacı AM, Akın F, Karaarslan S (September 1, 2013) Vazovagal senkoplu çocuklarda klinik değerlendirme ve takip sonuçları. Dicle Medical Journal 40 3 369–373.
IEEE A. M. Elmacı, F. Akın, and S. Karaarslan, “Vazovagal senkoplu çocuklarda klinik değerlendirme ve takip sonuçları”, diclemedj, vol. 40, no. 3, pp. 369–373, 2013, doi: 10.5798/diclemedj.0921.2013.03.0291.
ISNAD Elmacı, Ahmet Midhat et al. “Vazovagal Senkoplu çocuklarda Klinik değerlendirme Ve Takip sonuçları”. Dicle Medical Journal 40/3 (September 2013), 369-373. https://doi.org/10.5798/diclemedj.0921.2013.03.0291.
JAMA Elmacı AM, Akın F, Karaarslan S. Vazovagal senkoplu çocuklarda klinik değerlendirme ve takip sonuçları. diclemedj. 2013;40:369–373.
MLA Elmacı, Ahmet Midhat et al. “Vazovagal Senkoplu çocuklarda Klinik değerlendirme Ve Takip sonuçları”. Dicle Medical Journal, vol. 40, no. 3, 2013, pp. 369-73, doi:10.5798/diclemedj.0921.2013.03.0291.
Vancouver Elmacı AM, Akın F, Karaarslan S. Vazovagal senkoplu çocuklarda klinik değerlendirme ve takip sonuçları. diclemedj. 2013;40(3):369-73.