Syncope in pediatric patients presenting to an emergency department.
OBJECTIVE
To assess the epidemiology of syncope coming to medical attention among unselected children referred to an emergency department in Western Europe.


METHODS
We analyzed the cause of syncope and diagnostic workup of 226 consecutive pediatric patients seen in our emergency department because of a syncopal event.


RESULTS
Neurocardiogenic syncope and neurologic disorders were the most common diagnoses (80% and 9%, respectively). Other causes included psychologic, cardiac, respiratory, toxicologic, and metabolic problems. The neurocardiogenic and disease-related syncopes were easily identified or suspected by history and physical examination. Electrocardiography was not performed in 132 cases (58%). Most patients with suspected neurocardiogenic syncope had an electroencephalogram, and 29% were admitted to the hospital. Cardiac disorders represented 5 cases (2%); 2 had been previously misdiagnosed.


CONCLUSIONS
Syncope in children can result from a wide variety of causes. Consequently, an evaluation that fails to approach this problem in a goal-directed fashion proves to be very expensive, time-consuming, and frustrating to all concerned. Thorough history and physical examination are usually all that are necessary to guide practitioners in choosing the diagnostic tests that apply to a given patient.
Department of Pediatrics and Mathematical Institute, University of Liège, Liège, Belgium. martial.massin@chrcitadelle.be
Martial M
MM
Massin
Astrid
A
Bourguignont
Christine
C
Coremans
Laetitia
L
Comté
Philippe
P
Lepage
Paul
P
Gérard
D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013575:Syncope / Q000175:diagnosis* / Q000209:etiology*; D019462:Syncope, Vasovagal