630 Sincopes in Children and Participe Cardiac Diseases in Etiology

Abstract

Sincope is a sudenly, transient loss of consciousness, caused by interruption of essential energy substrates to the brain. Some of the reasons are different heart diseases, which cause a sudden fall in cardiac output. There are usually during exertion, and need urgent treament.Aim was to show participation heart diseases in etiology sincope in pediatric patients reffered to our clinic between 2004-2008.y.Methods: This study includes 153 children, with one or repetitive sincopes, without patients with clear clinic presentation for neurologic sincope. In all patients we have done physical examination of the cardiovascular system and surface ECG. Some patients have undergone echocardiography, ambulatory 24hour(Holter) ECG and exercise testing.Results: The most of all examined patients, 106(62,09%), had neurally mediated reflexive and orthostatic sincope. The most of them are teenagers. Six patients with neurally mediated sincope have mitral valve prolapse, without arrythmias. In 32(20,91%) we havenct founded etiology, but we excluded heart diseases and 17(11,11%) of them have neurologic sincope probably. But only 4 patients (2,61%) have diagnosed heart disease. One patient have VT exertion related, another patient have cardiac tumor (right ventricle). Third patient have aoric valve stenosis, grade middle to severely. And finally with congenital long QT syndrome.Conclusions: Sincope is one of the most often reason for referreing patients to cardiologist in our clinic. But small number of them have heart disease, and always seriosly. The reason is probably good organisation pediatric and cardiology services and discovering heart diseases in early stage, with following and treatment in time.