Abstract
Background: The etiology of syncope in young adults is poorly defined and most studies reveal benign etiologies. However, case reports suggest that exercise-related syncope, even in young patients, can be a harbinger of sudden cardiac death. We aim to determine the characteristics of young adults presenting with syncope in a diverse population of navy recruits. Methods: A retrospective chart review was performed on all Navy recruits who presented with a complaint of syncope to the Captain James A. Lovell Federal Health Care Center (JALFHCC) between June 1, 2006 and May 31, 2013. There was a total of 154 charts. Demographics and clinical data, along with Electrocardiogram (EKG), telemetry, and echocardiographic findings were recorded. Variables were compared between the subjects with abnormal cardiac profile and subjects with normal cardiac results. Results: The sample size of 154 included 95 males and 59 females. There were 13 (8.4%) subjects who were found to have concerned cardiac findings; 9 were males (9.5% of males) and 4 were females (6.8% of females). Compared to those without cardiac findings, there were no significant differences in age (20.2 ± 3.8 vs. 20.2 ± 2.5 years), body mass index (25.8 ± 2.8 vs. 24.7 ± 3.5), prior history of syncope (23 vs. 21%), or presence of exertional syncope (77 vs. 63%). Conclusion: A significant proportion of young American navy recruits have evidence of concerning electro and echocardiographic findings. We did not find any clinical profile predicting such findings although there was a statistically insignificant, but noticeable trend towards exertional syncope in those who had concerning cardiac abnormalities.
Highlights
Syncope is a prevalent medical condition that accounts for 3.5% of all emergency room visits and 1 to 6% of all hospital admissions annually in the United States [1]
We studied young American navy recruits who presented in the inpatient or outpatient settings
Patients with syncope including both exertional and non-exertional syncope were evaluated by conventional diagnostic tests; Electrocardiogram [EKG], cardiac monitoring on telemetry as achieved by admission to the hospital, Echocardiogram, and further work up as determined to be clinically indicated by the attending clinician and/or associated consult services
Summary
Syncope is a prevalent medical condition that accounts for 3.5% of all emergency room visits and 1 to 6% of all hospital admissions annually in the United States [1]. The etiologies of syncope in the young remain poorly characterized with most of the literature focusing on benign conditions such as psychiatric and neuro-cardiogenic causes [2,4-8]. O’Connor et al have reported exertion-related syncope in young athletes with and without history of cardiac disease leading to sudden cardiac death [7]. These findings may suggest that syncope, most commonly exertional in nature, may not be limited to benign causes in the young population especially amongst patients with underlying heart conditions such as hypertrophic cardiomyopathy and a history of strenuous exercise. Case reports suggest that exercise-related syncope, even in young patients, can be a harbinger of sudden cardiac death. We aim to determine the characteristics of young adults presenting with syncope in a diverse population of navy recruits
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