Abstract
(1) Background: The features characterizing vasovagal syncope (VVS) are an important factor in the correct evaluation of diagnostic risk stratification in children and adolescents. The aim of the study was to determine the value of identifying the clinical characteristics in children with VVS. (2) Methods: We made a retrospective analysis of the medical records of 109 children with diagnosed VVS. We investigated the specific characteristics of syncope in children with VVS including the positive VVS (+) and negative VVS (−) result of the Head-Up Tilt Table Test (HUTT). (3) Results: We did not observe significant differences in the prodromal symptoms of VVS with HUTT response. In addition to typical prodromal symptoms, no difference in statistically reported palpitations (35/109 or 32.1%) and chest discomfort (27/109 or 27.7%) were recorded. Fear–pain–stress emotions as circumstances of syncope were more often reported by children with a negative HUTT (p = 0.02). Cramps–contractures (p = 0.016) and speech disorders (p = 0.038) were significantly higher in the group with negative HUTT. (4) Conclusions: There is a close relationship in the diagnostic profile between the negative and positive results of head-up tilt table test in children with vasovagal syncope.
Highlights
Syncope is defined as a spontaneous and transient loss of consciousness (TLoc) due to a generalized decrease in cerebral perfusion
We compared the characteristics of a group of children and adolescents with VVS with positive results of the head-up tilt table test, VVS (+), with those with negative results in the HUTT, VVS (−)
A total of 109 patients with final diagnosis VVS were included in this study. All these patients with recurrent syncope with including criteria were referred for HUTT evaluation, and 60 of these (55.1%) had a positive result of HUTT (+)
Summary
Syncope is defined as a spontaneous and transient loss of consciousness (TLoc) due to a generalized decrease in cerebral perfusion. It is characterized by a rapid onset, short duration, and self-contained recovery that does not require intervention [1]. The most common loss of consciousness in young people include vasovagal syncope (VVS), known as reflexive, neurogenic, or neurocardiogenic. It is believed that in approximately 10% of children, determining the cause of syncope is unsuccessful [3,7,8]. The careful history taking of the characterizing clinical features of VVS, allow for the cause of syncope in the initial evaluation to be defined [1,3]. When a neurocardiogenic cause of syncope is suspected and heart diseases are excluded, a head-up tilt table test (HUTT) is used, due to which it is possible to confirm the diagnosis of VVS [9,10]
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