Retrospective analysis of 1020 pediatric cases with syncope who referred to pediatric emergency department

Abstract

Introduction: Syncope is transient loss of conscious due to cerebral hypoperfusion, characterized by a rapid onset, short duration with loss of posture and tonus in which etiology varies from benign to serious health problems. In this study diagnostic tests and results had been evaluated in children with syncope who referred to emergency department. Methods: Between 1 October 2012 and 1 October 2017,the demographic findings and results of cardiac and neurophysiological tests of 1020 patients (age range 1-18 years) were retrospectively analysed. Demographic and clinical characteristics, electrocardiography recordings, complete blood count, serum electrolytes, echocardiography, brain magnetic resonance and / or computed tomography imaging, electroencephalography and 24-hour Holter electrocardiography rhythm analysis tests were retrospectively reviewed. Results: 416 patients (40.78%) were male and 604 of them (59.21%) were female. The mean age was 12.82±4.88 years. There was only one syncope attack in 365 cases (35.78%); the rest had more than one. Electrocardiography was performed in all patients. Echocardiography had been performed in 566 cases (55.49%);brain magnetic rezonans imaging in 128 patients (12.54%), brain computed tomography in 214 patients (20,98%); electroencephalograph in 307 patients(30.09%) and 24 hour holter electrocardiography monitoring in 158 patients (15.49%). The most common was reflex / neural mediated syncope (n=561, 55.0%). Conclusion: Although syncope seen in childhood is usually innocent pathologies, it may also present as a sign of underlying serious cardiac, neurological or metabolic problems. To prevent unnecessary further examination, detailed history with good physical examination and electrocardiography should be needed in all pediatric patients with syncope. 

Keywords

• Children,pediatric emergency service,epilepsy,syncope

Çocuk acil servise senkop nedeniyle getirilen 1020 olgunun geriye dönük değerlendirilmesi

Abstract

Amaç: Senkop basit fizyolojik değişikliklerden, yaşamı tehdit eden ciddi hastalıklara kadar pek çok nedene bağlı olarak gelişebilen, postür ve tonus kaybıyla giden kısa süreli geçici bir bilinç kaybıdır. Bu çalışmada senkop nedeniyle çocuk acile getirilen olgularda, tanısal amaçlı yapılan testler ve sonuçları değerlendirildi. Yöntem: Çalışmaya Ekim 2012-Ekim 2017 tarihleri arasında Mersin Üniversitesi Tıp Fakültesi Çocuk Acil Servisi’ne, senkop nedeniyle getirilen, 1-18 yaş arasındaki 1020 olgu dahil edildi. Hastaların demografik ve klinik özellikleri, elektrokardiyografi kayıtları, tam kan sayımı, serum elektrolitleri, ekokardiyografi, beyin manyetik rezonans ve/veya bilgisayarlı tomografi görüntülemesi, elektroensefalografi ve 24 saatlik Holter elektrokardiyografi ritim analizi testleri dosya kayıtlarından geriye dönük olarak incelendi. Bulgular: Çalışmaya alınan hastaların 416’sı (%40.78) erkek, 604’ü (%59.21) kız hasta olup yaş ortalaması 12.82±4.88 yıl idi. Olguların 365’i (%35.78) bir, 566’sı (%55.49) iki, 75’i (%7.34) üç ve 14’ü (%1.37) üçün üzerinde senkop atağı geçirmişti. Hastaların hepsine elektrokardiyografi, 566’sına (%55.49) ekokardiyografi, 128'ine (%12.54) beyin manyetik rezonans görüntüleme, 214'üne (%20.98) beyin bilgisayarlı tomografi, 307'sine (%30.09) elektroensefalografi ve 158'ine (%15.49) 24 saatlik holter elektrokardiyografi analizi yapılmıştı. En sık görüleni refleks/nöral aracılı senkoplardı (n=561, %55.0). Sonuç: Çocukluk çağında görülen senkoplar, genellikle masum patolojiler olmasına karşın, nadir de olsa altta yatan ciddi kardiyak, nörolojik veya metabolik problemlerin bir bulgusu olarak da karşımıza çıkabilirler. Senkopla başvuran tüm çocuk hastalarda gereksiz ileri incelemelerin önüne geçilebilmesi için ayrıntılı öykü ile tam bir sistemik muayene ve elektrokardiyografi yapılması önem taşımaktadır.

Keywords

• Çocuk,Çocuk Acil Servis,,Senkop,Epilepsi

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