Treatment Of Syncope In Children Research Articles

2018 Chinese Pediatric Cardiology Society guideline interpretation for diagnosis and treatment of syncope in children and adolescents

2018 Chinese Pediatric Cardiology Society (CPCS) for the diagnosis and treatment of syncope in children and (referred as the new guideline ) was published in international journals.New in combination with the recent large number of clinical research in this field both at home and abroad, deve-loped by the experts of Pediatric Cardiology Society, Chinese Pediatric Society, Chinese Medical Association (CMA)/Committee on Pediatric Syncope, Pediatricians Branch, Chinese Medical Doctor Association (CMDA)/Committee on Pediatric Cardiology, Chinese College of Cardiovascular Physicians, Chinese Medical Doctor Association (CMDA)/Pe-diatric Cardiology Society, Beijing Pediatric Society, Beijing Medical Association (BMA), after repeated research and discussion.The guidelines effectively standardizes the diagnosis, differential diagnosis and prevention strategies of syncope diseases in children and adolescents.Based on the evidence evaluation of evidence-based medicine, the methodology of head-up tilt table test is partially updated, the precautions before the test are emphasized, and the characteristics and safety of children and adolescents are evaluated.In terms of prevention and treatment, the importance of healthy education is emphasized.The prognosis of postural tachycardia syndrome is added in the follow-up of efficacy. Key words: Child; Adolescent; Syncope; Diagnosis; Treatment; Guideline interpretation

Comments on 2018 CPCS guideline for diagnosis and treatment of syncope in children and adolescents

Comments on 2018 CPCS guideline for diagnosis and treatment of syncope in children and adolescents

2018 Chinese Pediatric Cardiology Society (CPCS) guideline for diagnosis and treatment of syncope in children and adolescents

Syncope belongs to the transient loss of consciousness (TLOC), characterized by a rapid onset, short duration, and spontaneous complete recovery. It is common in children and adolescents, accounting for 1% to 2% of emergency department visits.Recurrent syncope can seriously affect children's physical and mental health, learning ability and quality of life and sometimes cardiac syncope even poses a risk of sudden death. The present guideline for the diagnosis and treatment of syncope in children and adolescents was developed for guiding a better clinical management of pediatric syncope. Based on the globally recent development and the evidence-based data in China, 2018 Chinese Pediatric Cardiology Society (CPCS) guideline for diagnosis and treatment of syncope in children and adolescents was jointly prepared by the Pediatric Cardiology Society, Chinese Pediatric Society, Chinese Medical Association (CMA)/Committee on Pediatric Syncope, Pediatricians Branch, Chinese Medical Doctor Association (CMDA)/Committee on Pediatric Cardiology, Chinese College of Cardiovascular Physicians, Chinese Medical Doctor Association (CMDA)/Pediatric Cardiology Society, Beijing Pediatric Society, Beijing Medical Association (BMA). The present guideline includes the underlying diseases of syncope in children and adolescents, the diagnostic procedures, methodology and clinical significance of standing test and head-up tilt test, the clinical diagnosis vasovagal syncope, postural orthostatic tachycardia syndrome, orthostatic hypotension and orthostatic hypertension, and the treatment of syncope as well as follow-up.

A new guideline for diagnosis and treatment of syncope in children and adolescents that stimulates further thought and discussion

A new guideline for diagnosis and treatment of syncope in children and adolescents was published by Chinese Pediatric Cardiology Society (CPCS). This guideline admirably outlines a differential diagnosis of syncope in the Chinese population, placing appropriate emphasis on vasovagal syncope (VVS, simple faint), the most common cause. The authors appropriately discuss other more ominous causes of syncope such as cardiogenic syncope and neurogenic orthostatic hypotension. In particular, cardiogenic syncope can have lethal consequences if not promptly treated. The paper provides a useful algorithm for diagnostic evaluation of syncope patients placing primary emphasis on history, physical exam, and ECG, and further discussing testing procedures such as standing tests used in screening patients, and upright tilt table testing which remains the reference standard for orthostatic testing in younger patients. Indeed, most vasovagal and other forms of reflex or situational syncopes can be best diagnosed on clinical history. The authors further consider other forms of orthostatic intolerance such as orthostatic hypertension, postural tachycardia syndrome (POTS), and “initial orthostatic hypotension” experienced as transient lightheadedness upon rapid standing. The authors regard POTS as a cause of vasovagal syncope. This supposition is controversial and deserves further comment.

Individualized Treatment of Syncope in Children: State-of-the-Art.

Individualized Treatment of Syncope in Children: State-of-the-Art.

Effectiveness of fludrocortisone and salt in preventing syncope recurrence in children: A double-blind, placebo-controlled, randomized trial

We sought to evaluate the effectiveness of salt and fludrocortisone versus placebo in the prevention of syncope recurrence in children. Intravascular volume expansion with fludrocortisone and salt has been reported to be effective in the treatment of syncope in children. However, no pediatric placebo-controlled data are available on the effectiveness of this mode of therapy. Thirty-three children with syncope or severe presyncope were randomized in a double-blinded fashion to receive either fludrocortisone 0.1 mg/day and salt 1 g/day or placebo two capsules per day for one year. All children had a positive tilt test before enrollment. Thirty-two children (20 female) had follow-up. Their age was (mean +/- SD) 13.9 +/- 2.5 years. The number of syncopal episodes before therapy was 4.4 +/- 4.8. Therapy was continued for 176 +/- 117 days, and follow-up including time after discontinuation of medications was 1.2 +/- 0.8 years. The demographics were similar in the 18 children treated with fludrocortisone and salt compared with the 14 children on placebo. Data for up to one year of randomization were included in analyses. Symptoms recurred in 10 of 18 children on fludrocortisone and salt and in 5 of 14 children on placebo (p < 0.04). Children on placebo had no symptoms until they discontinued their study medications. These data, coupled with the reported comparable effect of many medications used in the treatment of syncope, raise the potential of a significant placebo effect with pharmacologic therapy.

Cardiologie fœtale

Syncope belongs to the transient loss of consciousness (TLOC), characterized by a rapid onset, short duration, and spontaneous complete recovery. It is common in children and adolescents, accounting for 1% to 2% of emergency department visits.Recurrent syncope can seriously affect children's physical and mental health, learning ability and quality of life and sometimes cardiac syncope even poses a risk of sudden death. The present guideline for the diagnosis and treatment of syncope in children and adolescents was developed for guiding a better clinical management of pediatric syncope. Based on the globally recent development and the evidence-based data in China, 2018 Chinese Pediatric Cardiology Society (CPCS) guideline for diagnosis and treatment of syncope in children and adolescents was jointly prepared by the Pediatric Cardiology Society, Chinese Pediatric Society, Chinese Medical Association (CMA)/Committee on Pediatric Syncope, Pediatricians Branch, Chinese Medical Doctor Association (CMDA)/Committee on Pediatric Cardiology, Chinese College of Cardiovascular Physicians, Chinese Medical Doctor Association (CMDA)/Pediatric Cardiology Society, Beijing Pediatric Society, Beijing Medical Association (BMA). The present guideline includes the underlying diseases of syncope in children and adolescents, the diagnostic procedures, methodology and clinical significance of standing test and head-up tilt test, the clinical diagnosis vasovagal syncope, postural orthostatic tachycardia syndrome, orthostatic hypotension and orthostatic hypertension, and the treatment of syncope as well as follow-up.